- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,288.25 / $3,890.45
| Facility | | $524.81 | $1,288.25 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $2,137.96 / $3,090.30
| Facility | | $1,174.90 | $2,137.96 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $363.08 / $630.96
| Facility | | $39.81 | $363.08 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $575.44 / $977.24
| Facility | | $489.78 | $575.44 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,412.54 / $3,981.07
| Facility | | $467.74 | $1,412.54 | $3,981.07 |