- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,513.56 / $8,511.38
| Facility | | $407.38 | $1,513.56 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,398.83 / $5,128.61
| Facility | | $1,479.11 | $2,398.83 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $354.81 / $501.19
| Facility | | $288.40 | $354.81 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $1,659.59
| Facility | | $562.34 | $562.34 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,698.24 / $6,309.57
| Facility | | $575.44 | $1,698.24 | $6,309.57 |