- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $4,897.79 / $16,218.10
| Facility | | $616.60 | $4,897.79 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $8,511.38 / $11,220.18
| Facility | | $3,981.07 | $8,511.38 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $562.34 / $630.96
| Facility | | $537.03 | $562.34 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,238.72 / $2,238.72
| Facility | | $2,238.72 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $6,025.60 / $10,715.19
| Facility | | $2,691.53 | $6,025.60 | $10,715.19 |