- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $3,801.89 / $5,623.41
| Facility | | $151.36 | $3,801.89 | $5,623.41 |
- 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
- $134.90 / $141.25 / $158.49
| Facility | | $134.90 | $141.25 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $758.58 / $1,148.15
| Facility | | $234.42 | $758.58 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,715.35 / $6,456.54
| Facility | | $1,412.54 | $3,715.35 | $6,456.54 |