- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $3,630.78 / $8,128.31
| Facility | | $436.52 | $3,630.78 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,951.21 / $3,090.30
| Facility | | $467.74 | $2,951.21 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $524.81 / $6,456.54
| Facility | | $263.03 | $524.81 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,290.87 / $4,677.35
| Facility | | $1,548.82 | $2,290.87 | $4,677.35 |