- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,513.56 / $5,495.41
| Facility | | $407.38 | $1,513.56 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,235.94 / $15,848.93
| Facility | | $1,584.89 | $3,235.94 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $229.09 / $269.15
| Facility | | $162.18 | $229.09 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $309.03 / $1,659.59
| Facility | | $239.88 | $309.03 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,445.44 / $5,248.07
| Facility | | $524.81 | $1,445.44 | $5,248.07 |