- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $6,025.60 / $16,595.87
| Facility | | $354.81 | $6,025.60 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,265.80 / $7,943.28
| Facility | | $2,041.74 | $4,265.80 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $1,659.59
| Facility | | $501.19 | $501.19 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $269.15 / $416.87
| Facility | | $134.90 | $269.15 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,964.78 / $16,982.44
| Facility | | $1,995.26 | $10,964.78 | $16,982.44 |