- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $2,137.96 / $7,244.36
| Facility | | $288.40 | $2,137.96 | $7,244.36 |
- 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
- $234.42 / $245.47 / $275.42
| Facility | | $234.42 | $245.47 | $275.42 |
- 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 |