- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $1,513.56 / $5,495.41
| Facility | | $120.23 | $1,513.56 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,398.83 / $4,365.16
| Facility | | $1,479.11 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $144.54 / $169.82
| Facility | | $112.20 | $144.54 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $1,659.59
| Facility | | $213.80 | $213.80 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,445.44 / $5,248.07
| Facility | | $524.81 | $1,445.44 | $5,248.07 |