- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $3,890.45 / $9,120.11
| Facility | | $380.19 | $3,890.45 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $4,466.84 / $4,677.35
| Facility | | $575.44 | $4,466.84 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $380.19 / $3,162.28
| Facility | | $177.83 | $380.19 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,137.96 / $3,311.31
| Facility | | $1,023.29 | $2,137.96 | $3,311.31 |