- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $2,089.30 / $8,709.64
| Facility | | $426.58 | $2,089.30 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $8,511.38 / $13,803.84
| Facility | | $1,380.38 | $8,511.38 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $1,659.59
| Facility | | $512.86 | $512.86 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $407.38 / $691.83
| Facility | | $288.40 | $407.38 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $6,025.60 / $14,454.40
| Facility | | $645.65 | $6,025.60 | $14,454.40 |