- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,290.87 / $9,332.54
| Facility | | $776.25 | $2,290.87 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $18,197.01 / $26,302.68
| Facility | | $4,365.16 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $707.95 / $794.33
| Facility | | $630.96 | $707.95 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,071.52 / $1,479.11
| Facility | | $776.25 | $1,071.52 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $7,762.47 / $10,964.78
| Facility | | $1,621.81 | $7,762.47 | $10,964.78 |