- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $2,344.23 / $5,623.41
| Facility | | $239.88 | $2,344.23 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $8,317.64 / $10,471.29
| Facility | | $3,715.35 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $213.80 / $239.88
| Facility | | $204.17 | $213.80 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,288.25 / $1,288.25
| Facility | | $1,288.25 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,025.60 / $10,715.19
| Facility | | $1,698.24 | $6,025.60 | $10,715.19 |