- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $3,630.78 / $8,511.38
| Facility | | $446.68 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,801.89 / $3,981.07
| Facility | | $2,041.74 | $3,801.89 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $7,079.46 / $7,079.46
| Facility | | $7,079.46 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $616.60 / $6,025.60
| Facility | | $269.15 | $616.60 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,511.89 / $4,677.35
| Facility | | $1,548.82 | $2,511.89 | $4,677.35 |