- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $4,897.79 / $7,244.36
| Facility | | $204.17 | $4,897.79 | $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
- $181.97 / $190.55 / $213.80
| Facility | | $181.97 | $190.55 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $316.23 / $467.74
| Facility | | $213.80 | $316.23 | $467.74 |
- 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 |