- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $1,513.56 / $5,495.41
| Facility | | $281.84 | $1,513.56 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,398.83 / $4,365.16
| Facility | | $1,479.11 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $338.84 / $446.68
| Facility | | $251.19 | $338.84 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $467.74 / $1,659.59
| Facility | | $436.52 | $467.74 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $6,309.57
| Facility | | $602.56 | $2,754.23 | $6,309.57 |