- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $1,412.54 / $5,370.32
| Facility | | $245.47 | $1,412.54 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,801.89 / $8,511.38
| Facility | | $2,290.87 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $194.98 / $251.19
| Facility | | $134.90 | $194.98 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $263.03 / $1,862.09
| Facility | | $263.03 | $263.03 | $1,862.09 |
- 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 |