- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $1,995.26 / $5,623.41
| Facility | | $158.49 | $1,995.26 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,317.64 / $10,471.29
| Facility | | $2,344.23 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $144.54 / $165.96
| Facility | | $138.04 | $144.54 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $870.96 / $1,698.24
| Facility | | $162.18 | $870.96 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,715.35 / $6,456.54
| Facility | | $1,412.54 | $3,715.35 | $6,456.54 |