- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $1,778.28 / $8,511.38
| Facility | | $263.03 | $1,778.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $3,801.89 / $8,511.38
| Facility | | $2,344.23 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $269.15 / $323.59
| Facility | | $194.98 | $269.15 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $363.08 / $363.08
| Facility | | $34.67 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $6,309.57
| Facility | | $602.56 | $2,754.23 | $6,309.57 |