- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $4,897.79 / $7,244.36
| Facility | | $213.80 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $8,317.64 / $10,471.29
| Facility | | $2,187.76 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $144.54 / $165.96
| Facility | | $138.04 | $144.54 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $380.19 / $1,905.46
| Facility | | $151.36 | $380.19 | $1,905.46 |
- 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 |