- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $5,370.32 / $15,848.93
| Facility | | $229.09 | $5,370.32 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $13,803.84 / $19,054.61
| Facility | | $3,715.35 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $186.21
| Facility | | $181.97 | $181.97 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $309.03 / $549.54
| Facility | | $204.17 | $309.03 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $6,025.60 / $10,715.19
| Facility | | $2,398.83 | $6,025.60 | $10,715.19 |