- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $1,513.56 / $8,511.38
| Facility | | $218.78 | $1,513.56 | $8,511.38 |
- 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
- $131.83 / $162.18 / $229.09
| Facility | | $131.83 | $162.18 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $263.03 / $1,659.59
| Facility | | $263.03 | $263.03 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,348.96 / $5,248.07
| Facility | | $524.81 | $1,348.96 | $5,248.07 |