- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $3,388.44 / $8,317.64
| Facility | | $257.04 | $3,388.44 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,288.25 / $1,778.28
| Facility | | $954.99 | $1,288.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,398.83 / $8,709.64
| Facility | | $1,288.25 | $2,398.83 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $169.82 / $549.54
| Facility | | $107.15 | $169.82 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $524.81 / $1,905.46
| Facility | | $165.96 | $524.81 | $1,905.46 |