- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $3,467.37 / $11,220.18
| Facility | | $588.84 | $3,467.37 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $8,317.64 / $10,471.29
| Facility | | $3,715.35 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $398.11 / $446.68
| Facility | | $380.19 | $398.11 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $630.96 / $812.83
| Facility | | $398.11 | $630.96 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $7,762.47 / $10,964.78
| Facility | | $2,884.03 | $7,762.47 | $10,964.78 |