- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $5,888.44 / $12,589.25
| Facility | | $407.38 | $5,888.44 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $8,511.38 / $11,220.18
| Facility | | $3,801.89 | $8,511.38 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $309.03 / $346.74
| Facility | | $295.12 | $309.03 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $478.63 / $630.96
| Facility | | $316.23 | $478.63 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $6,025.60 / $10,715.19
| Facility | | $2,137.96 | $6,025.60 | $10,715.19 |