- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $3,388.44 / $8,511.38
| Facility | | $407.38 | $3,388.44 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $5,248.07 / $12,022.64
| Facility | | $2,951.21 | $5,248.07 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $323.59 / $457.09
| Facility | | $263.03 | $323.59 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $2,511.89
| Facility | | $512.86 | $512.86 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,698.24 / $6,309.57
| Facility | | $575.44 | $1,698.24 | $6,309.57 |