- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $4,897.79 / $11,220.18
| Facility | | $416.87 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $8,317.64 / $10,471.29
| Facility | | $3,715.35 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $371.54 / $426.58
| Facility | | $363.08 | $371.54 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $575.44 / $707.95
| Facility | | $363.08 | $575.44 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,025.60 / $10,715.19
| Facility | | $3,388.44 | $6,025.60 | $10,715.19 |