- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $4,897.79 / $7,244.36
| Facility | | $691.83 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,317.64 / $10,471.29
| Facility | | $2,344.23 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $501.19 / $562.34
| Facility | | $457.09 | $501.19 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,230.27 / $1,479.11
| Facility | | $1,230.27 | $1,230.27 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $6,025.60 / $10,715.19
| Facility | | $1,621.81 | $6,025.60 | $10,715.19 |