- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,047.13 / $7,762.47
| Facility | | $295.12 | $1,047.13 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,090.30 / $5,128.61
| Facility | | $724.44 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $741.31
| Facility | | $354.81 | $354.81 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $602.56 / $1,096.48
| Facility | | $218.78 | $602.56 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,467.37 / $5,248.07
| Facility | | $562.34 | $3,467.37 | $5,248.07 |