- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,659.59 / $4,168.69
| Facility | | $645.65 | $1,659.59 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $4,570.88 / $6,918.31
| Facility | | $2,511.89 | $4,570.88 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $154.88 / $1,819.70
| Facility | | $39.81 | $154.88 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $524.81 / $2,754.23
| Facility | | $316.23 | $524.81 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,445.44 / $4,786.30
| Facility | | $467.74 | $1,445.44 | $4,786.30 |