- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,288.25 / $5,495.41
| Facility | | $257.04 | $1,288.25 | $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
- $177.83 / $218.78 / $309.03
| Facility | | $177.83 | $218.78 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $1,659.59
| Facility | | $354.81 | $354.81 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $398.11 / $3,162.28
| Facility | | $50.12 | $398.11 | $3,162.28 |