- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $1,047.13 / $7,762.47
| Facility | | $239.88 | $1,047.13 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,311.31 / $5,248.07
| Facility | | $1,445.44 | $3,311.31 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $288.40 / $741.31
| Facility | | $288.40 | $288.40 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $257.04 / $467.74
| Facility | | $165.96 | $257.04 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,467.37 / $5,248.07
| Facility | | $562.34 | $3,467.37 | $5,248.07 |