- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $2,818.38 / $8,511.38
| Facility | | $77.62 | $2,818.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $9,120.11 / $11,220.18
| Facility | | $371.54 | $9,120.11 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $93.33 / $109.65
| Facility | | $72.44 | $93.33 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $141.25 / $141.25
| Facility | | $34.67 | $141.25 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,445.44 / $5,248.07
| Facility | | $524.81 | $1,445.44 | $5,248.07 |