- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.20 / $2,145.78 / $7,838.38
| Facility | | $421.20 | $2,145.78 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,643.21 / $8,978.04 / $14,642.01
| Facility | | $3,643.21 | $8,978.04 | $14,642.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.38 / $315.38 / $419.81
| Facility | | $315.38 | $315.38 | $419.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.25 / $359.31 / $494.39
| Facility | | $244.25 | $359.31 | $494.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.00 / $3,085.00 / $5,060.00
| Facility | | $755.00 | $3,085.00 | $5,060.00 |