- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $4,365.16 / $8,317.64
| Facility | | $616.60 | $4,365.16 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $7,943.28 / $7,943.28
| Facility | | $7,585.78 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $512.86 / $12,882.50
| Facility | | $295.12 | $512.86 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $5,623.41 / $10,715.19
| Facility | | $2,818.38 | $5,623.41 | $10,715.19 |