- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,162.28 / $7,413.10
| Facility | | $660.69 | $3,162.28 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,819.70 / $4,168.69
| Facility | | $676.08 | $1,819.70 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Facility | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $1,318.26 / $16,218.10
| Facility | | $457.09 | $1,318.26 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,398.83 / $4,677.35
| Facility | | $1,737.80 | $2,398.83 | $4,677.35 |