- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,778.28 / $8,128.31
| Facility | | $691.83 | $1,778.28 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $3,801.89 / $8,511.38
| Facility | | $1,995.26 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $758.58 / $977.24
| Facility | | $616.60 | $758.58 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $2,290.87
| Facility | | $1,122.02 | $1,122.02 | $2,290.87 |
- 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 |