- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $2,630.27 / $8,511.38
| Facility | | $478.63 | $2,630.27 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $3,801.89 / $8,511.38
| Facility | | $2,344.23 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $630.96 / $741.31
| Facility | | $446.68 | $630.96 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $851.14 / $851.14
| Facility | | $34.67 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $6,309.57
| Facility | | $602.56 | $2,754.23 | $6,309.57 |