- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,949.84 / $9,120.11
| Facility | | $630.96 | $1,949.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,073.80 / $9,549.93
| Facility | | $2,344.23 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $660.69 / $851.14
| Facility | | $524.81 | $660.69 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $977.24 / $2,511.89
| Facility | | $977.24 | $977.24 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $6,309.57
| Facility | | $602.56 | $2,754.23 | $6,309.57 |