- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $2,398.83 / $16,595.87
| Facility | | $275.42 | $2,398.83 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,454.71 / $4,786.30
| Facility | | $954.99 | $2,454.71 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,090.30 / $3,981.07
| Facility | | $3,090.30 | $3,090.30 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $457.09 / $1,584.89
| Facility | | $218.78 | $457.09 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |