- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $3,467.37 / $4,897.79
| Facility | | $114.82 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $4,073.80 / $8,317.64
| Facility | | $691.83 | $4,073.80 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $85.11
| Facility | | $79.43 | $79.43 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $125.89 / $165.96
| Facility | | $81.28 | $125.89 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $3,715.35 / $6,456.54
| Facility | | $707.95 | $3,715.35 | $6,456.54 |