- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,513.56 / $5,495.41
| Facility | | $537.03 | $1,513.56 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,398.83 / $4,365.16
| Facility | | $1,412.54 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $549.54 / $724.44
| Facility | | $446.68 | $549.54 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $1,862.09
| Facility | | $831.76 | $831.76 | $1,862.09 |
- 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 |