- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,318.26 / $3,890.45
| Facility | | $501.19 | $1,318.26 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,290.87 / $5,128.61
| Facility | | $1,047.13 | $2,290.87 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $181.97 / $602.56
| Facility | | $39.81 | $181.97 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $537.03 / $933.25
| Facility | | $331.13 | $537.03 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,348.96 / $3,388.44
| Facility | | $467.74 | $1,348.96 | $3,388.44 |