- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $1,548.82 / $6,456.54
| Facility | | $269.15 | $1,548.82 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $309.03
| Facility | | $257.04 | $257.04 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $407.38
| Facility | | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,981.07 / $8,912.51
| Facility | | $501.19 | $3,981.07 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,230.27 / $5,370.32
| Facility | | $1,230.27 | $1,230.27 | $5,370.32 |