- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $4,897.79 / $11,220.18
| Facility | | $389.05 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $18,197.01 / $26,302.68
| Facility | | $3,715.35 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $346.74 / $389.05
| Facility | | $331.13 | $346.74 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $549.54 / $676.08
| Facility | | $338.84 | $549.54 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $9,549.93 / $16,218.10
| Facility | | $4,168.69 | $9,549.93 | $16,218.10 |