- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $2,951.21 / $7,244.36
| Facility | | $223.87 | $2,951.21 | $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
- $190.55 / $199.53 / $223.87
| Facility | | $190.55 | $199.53 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $338.84 / $524.81
| Facility | | $199.53 | $338.84 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,715.35 / $6,456.54
| Facility | | $1,445.44 | $3,715.35 | $6,456.54 |