- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,288.25 / $3,715.35
| Facility | | $323.59 | $1,288.25 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,949.84 / $3,467.37
| Facility | | $1,148.15 | $1,949.84 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $91.20 / $831.76
| Facility | | $39.81 | $91.20 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $537.03 / $1,258.93
| Facility | | $173.78 | $537.03 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,412.54 / $4,168.69
| Facility | | $467.74 | $1,412.54 | $4,168.69 |