- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $3,890.45 / $7,244.36
| Facility | | $398.11 | $3,890.45 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,466.84 / $8,317.64
| Facility | | $2,089.30 | $4,466.84 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $281.84
| Facility | | $275.42 | $275.42 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $467.74 / $741.31
| Facility | | $302.00 | $467.74 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,818.38 / $4,265.80
| Facility | | $588.84 | $2,818.38 | $4,265.80 |