- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $3,162.28 / $7,585.78
| Facility | | $489.78 | $3,162.28 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $1,071.52 / $1,202.26
| Facility | | $208.93 | $1,071.52 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $676.08 / $2,454.71
| Facility | | $602.56 | $676.08 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $295.12 / $1,513.56
| Facility | | $81.28 | $295.12 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $794.33 / $2,570.40
| Facility | | $467.74 | $794.33 | $2,570.40 |