- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,288.25 / $5,623.41
| Facility | | $323.59 | $1,288.25 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $8,317.64 / $10,471.29
| Facility | | $2,187.76 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $223.87 / $251.19
| Facility | | $213.80 | $223.87 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $489.78 / $977.24
| Facility | | $269.15 | $489.78 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,715.35 / $6,456.54
| Facility | | $977.24 | $3,715.35 | $6,456.54 |