- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $630.96 / $4,897.79
| Facility | | $354.81 | $630.96 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $8,317.64
| Facility | | $1,995.26 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $354.81 / $398.11
| Facility | | $323.59 | $354.81 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $489.78 / $812.83
| Facility | | $354.81 | $489.78 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $2,137.96 / $5,754.40
| Facility | | $199.53 | $2,137.96 | $5,754.40 |