- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $1,445.44 / $8,511.38
| Facility | | $194.98 | $1,445.44 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,137.96 / $2,951.21
| Facility | | $1,348.96 | $2,137.96 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $169.82 / $239.88
| Facility | | $138.04 | $169.82 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $1,318.26
| Facility | | $275.42 | $275.42 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $398.11 / $3,162.28
| Facility | | $50.12 | $398.11 | $3,162.28 |