- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $3,715.35 / $10,715.19
| Facility | | $218.78 | $3,715.35 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $281.84
| Facility | | $234.42 | $234.42 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $1,659.59
| Facility | | $371.54 | $371.54 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $7,943.28 / $13,182.57
| Facility | | $7,244.36 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $5,888.44
| Facility | | $2,454.71 | $2,454.71 | $5,888.44 |