- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,288.25 / $5,495.41
| Facility | | $537.03 | $1,288.25 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,235.94 / $9,332.54
| Facility | | $1,584.89 | $3,235.94 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $512.86 / $724.44
| Facility | | $371.54 | $512.86 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $1,659.59
| Facility | | $691.83 | $691.83 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $6,309.57
| Facility | | $602.56 | $2,754.23 | $6,309.57 |