- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,949.84 / $9,120.11
| Facility | | $676.08 | $1,949.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,073.80 / $9,549.93
| Facility | | $2,454.71 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $691.83 / $912.01
| Facility | | $562.34 | $691.83 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,047.13 / $2,511.89
| Facility | | $1,047.13 | $1,047.13 | $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 |