- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $3,801.89 / $5,623.41
| Facility | | $549.54 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $13,803.84 / $19,054.61
| Facility | | $2,187.76 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $371.54 / $416.87
| Facility | | $354.81 | $371.54 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $588.84 / $758.58
| Facility | | $371.54 | $588.84 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $9,549.93 / $16,218.10
| Facility | | $2,884.03 | $9,549.93 | $16,218.10 |