- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $6,165.95 / $14,791.08
| Facility | | $416.87 | $6,165.95 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,011.87 / $9,549.93
| Facility | | $2,137.96 | $5,011.87 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,230.27 / $1,584.89
| Facility | | $707.95 | $1,230.27 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $478.63 / $741.31
| Facility | | $331.13 | $478.63 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $10,964.78 / $16,982.44
| Facility | | $2,754.23 | $10,964.78 | $16,982.44 |