- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,897.79 / $11,220.18
| Facility | | $602.56 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $8,317.64 / $10,471.29
| Facility | | $3,715.35 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $407.38 / $457.09
| Facility | | $371.54 | $407.38 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $602.56 / $812.83
| Facility | | $407.38 | $602.56 | $812.83 |
- 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 |