- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $4,265.80 / $9,120.11
| Facility | | $128.82 | $4,265.80 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $2,290.87 / $4,570.88
| Facility | | $758.58 | $2,290.87 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $1,023.29
| Facility | | $812.83 | $812.83 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $173.78 / $446.68
| Facility | | $102.33 | $173.78 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $3,890.45 / $7,943.28
| Facility | | $1,122.02 | $3,890.45 | $7,943.28 |