- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $1,412.54 / $8,317.64
| Facility | | $213.80 | $1,412.54 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,801.89 / $8,511.38
| Facility | | $2,290.87 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $181.97 / $234.42
| Facility | | $138.04 | $181.97 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $1,862.09
| Facility | | $269.15 | $269.15 | $1,862.09 |
- 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 |