- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $1,698.24 / $6,760.83
| Facility | | $281.84 | $1,698.24 | $6,760.83 |
- 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
- $234.42 / $239.88 / $275.42
| Facility | | $234.42 | $239.88 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $1,148.15
| Facility | | $407.38 | $407.38 | $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 |