- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $3,467.37 / $7,244.36
| Facility | | $213.80 | $3,467.37 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,454.40 / $19,498.45
| Facility | | $6,456.54 | $14,454.40 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $194.98 / $223.87
| Facility | | $190.55 | $194.98 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $758.58 / $1,148.15
| Facility | | $331.13 | $758.58 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,715.35 / $6,456.54
| Facility | | $1,412.54 | $3,715.35 | $6,456.54 |