- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $4,897.79 / $8,128.31
| Facility | | $316.23 | $4,897.79 | $8,128.31 |
- 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
- $190.55 / $199.53 / $223.87
| Facility | | $190.55 | $199.53 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $251.19 / $398.11
| Facility | | $190.55 | $251.19 | $398.11 |
- 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 |