- 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
- $426.58 / $426.58 / $426.58
| Facility | | $426.58 | $426.58 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $645.65 / $1,621.81
| Facility | | $446.68 | $645.65 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,630.78 / $6,456.54
| Facility | | $912.01 | $3,630.78 | $6,456.54 |