- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,949.84 / $9,120.11
| Facility | | $707.95 | $1,949.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,073.80 / $9,549.93
| Facility | | $2,630.27 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $645.65 / $758.58
| Facility | | $467.74 | $645.65 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $870.96 / $2,290.87
| Facility | | $870.96 | $870.96 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,890.45 / $8,511.38
| Facility | | $741.31 | $3,890.45 | $8,511.38 |