- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.66 / $3,788.60 / $13,841.56
| Facility | | $236.66 | $3,788.60 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.78 / $448.29 / $841.55
| Facility | | $330.78 | $448.29 | $841.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.44 / $303.05 / $556.30
| Facility | | $91.44 | $303.05 | $556.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.32 / $352.67 / $479.06
| Facility | | $145.32 | $352.67 | $479.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |