- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $3,467.37 / $8,128.31
| Facility | | $398.11 | $3,467.37 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,548.82 / $2,454.71
| Facility | | $1,148.15 | $1,548.82 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $380.19 / $1,698.24
| Facility | | $229.09 | $380.19 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $537.03 / $1,905.46
| Facility | | $190.55 | $537.03 | $1,905.46 |