- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $1,071.52 / $5,248.07
| Facility | | $457.09 | $1,071.52 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $3,311.31 / $4,570.88
| Facility | | $3,311.31 | $3,311.31 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $436.52 / $616.60
| Facility | | $331.13 | $436.52 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $512.86 / $2,290.87
| Facility | | $489.78 | $512.86 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,819.70 / $7,079.46
| Facility | | $812.83 | $1,819.70 | $7,079.46 |