- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,548.82 / $4,168.69
| Facility | | $660.69 | $1,548.82 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $5,623.41 / $10,232.93
| Facility | | $2,630.27 | $5,623.41 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $2,290.87 / $2,290.87
| Facility | | $39.81 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,467.37 / $8,511.38
| Facility | | $1,023.29 | $3,467.37 | $8,511.38 |