- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $4,897.79 / $16,595.87
| Facility | | $151.36 | $4,897.79 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $2,570.40 / $4,570.88
| Facility | | $1,174.90 | $2,570.40 | $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
- $69.18 / $138.04 / $281.84
| Facility | | $69.18 | $138.04 | $281.84 |
- 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 |