- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $2,511.89 / $5,623.41
| Facility | | $524.81 | $2,511.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,168.69 / $6,025.60
| Facility | | $2,238.72 | $4,168.69 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $2,089.30 / $2,089.30
| Facility | | $147.91 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $812.83 / $2,041.74
| Facility | | $269.15 | $812.83 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,445.44 / $4,365.16
| Facility | | $467.74 | $1,445.44 | $4,365.16 |