- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $2,344.23 / $7,244.36
| Facility | | $181.97 | $2,344.23 | $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
- $147.91 / $154.88 / $173.78
| Facility | | $147.91 | $154.88 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $537.03 / $1,148.15
| Facility | | $263.03 | $537.03 | $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 |