- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $3,801.89 / $5,623.41
| Facility | | $208.93 | $3,801.89 | $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
- $186.21 / $194.98 / $218.78
| Facility | | $186.21 | $194.98 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $398.11 / $851.14
| Facility | | $331.13 | $398.11 | $851.14 |
- 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 |