- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $4,897.79 / $7,244.36
| Facility | | $281.84 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,317.64 / $10,471.29
| Facility | | $2,344.23 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $186.21 / $208.93
| Facility | | $169.82 | $186.21 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $1,318.26
| Facility | | $1,122.02 | $1,122.02 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,715.35 / $6,456.54
| Facility | | $1,348.96 | $3,715.35 | $6,456.54 |