- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $4,897.79 / $16,595.87
| Facility | | $257.04 | $4,897.79 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,168.69 / $7,943.28
| Facility | | $1,995.26 | $4,168.69 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $338.84 / $371.54
| Facility | | $263.03 | $338.84 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $223.87 / $436.52
| Facility | | $120.23 | $223.87 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,230.27 / $3,548.13
| Facility | | $380.19 | $1,230.27 | $3,548.13 |