- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,288.25 / $3,890.45
| Facility | | $575.44 | $1,288.25 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,570.88 / $7,079.46
| Facility | | $2,238.72 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $416.87 / $1,348.96
| Facility | | $39.81 | $416.87 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $575.44 / $2,041.74
| Facility | | $489.78 | $575.44 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,398.83 / $6,309.57
| Facility | | $831.76 | $2,398.83 | $6,309.57 |