- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,659.59 / $4,168.69
| Facility | | $660.69 | $1,659.59 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $5,370.32 / $7,585.78
| Facility | | $2,951.21 | $5,370.32 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $776.25 / $1,621.81
| Facility | | $39.81 | $776.25 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $812.83 / $2,454.71
| Facility | | $616.60 | $812.83 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,162.28 / $8,511.38
| Facility | | $912.01 | $3,162.28 | $8,511.38 |