- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $4,897.79 / $14,125.38
| Facility | | $389.05 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $4,365.16 / $10,964.78
| Facility | | $588.84 | $4,365.16 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $295.12
| Facility | | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $562.34 / $794.33
| Facility | | $489.78 | $562.34 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $2,238.72 / $5,754.40
| Facility | | $257.04 | $2,238.72 | $5,754.40 |