- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $2,398.83 / $7,413.10
| Facility | | $295.12 | $2,398.83 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,122.02 / $1,174.90
| Facility | | $954.99 | $1,122.02 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $794.33 / $2,454.71
| Facility | | $660.69 | $794.33 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $426.58 / $1,905.46
| Facility | | $151.36 | $426.58 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,202.26 / $3,311.31
| Facility | | $707.95 | $1,202.26 | $3,311.31 |