- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $3,801.89 / $5,623.41
| Facility | | $489.78 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $8,912.51 / $12,589.25
| Facility | | $4,265.80 | $8,912.51 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $346.74 / $389.05
| Facility | | $309.03 | $346.74 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $602.56 / $831.76
| Facility | | $380.19 | $602.56 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $2,238.72 / $7,413.10
| Facility | | $933.25 | $2,238.72 | $7,413.10 |