- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.20 / $7,838.38 / $8,644.27
| Facility | | $438.20 | $7,838.38 | $8,644.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,603.62 / $8,426.79 / $13,562.56
| Facility | | $1,603.62 | $8,426.79 | $13,562.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.02 / $346.02 / $1,651.99
| Facility | | $346.02 | $346.02 | $1,651.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.62 / $390.16 / $489.60
| Facility | | $290.62 | $390.16 | $489.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $6,599.00 / $7,158.00
| Facility | | $936.00 | $6,599.00 | $7,158.00 |