- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $1,513.56 / $8,511.38
| Facility | | $234.42 | $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
- $162.18 / $199.53 / $281.84
| Facility | | $162.18 | $199.53 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $1,659.59
| Facility | | $323.59 | $323.59 | $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 |