- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $741.31 / $7,762.47
| Facility | | $512.86 | $741.31 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $8,912.51 / $14,125.38
| Facility | | $2,511.89 | $8,912.51 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $616.60
| Facility | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $524.81 / $912.01
| Facility | | $371.54 | $524.81 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $6,025.60 / $25,703.96
| Facility | | $645.65 | $6,025.60 | $25,703.96 |