- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $4,897.79 / $6,456.54
| Facility | | $316.23 | $4,897.79 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $575.44
| Facility | | $295.12 | $295.12 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $257.04 / $302.00
| Facility | | $204.17 | $257.04 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $354.81 / $616.60
| Facility | | $223.87 | $354.81 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $2,290.87 / $7,413.10
| Facility | | $933.25 | $2,290.87 | $7,413.10 |