- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $4,897.79 / $10,232.93
| Facility | | $263.03 | $4,897.79 | $10,232.93 |
- 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
- $173.78 / $181.97 / $204.17
| Facility | | $173.78 | $181.97 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $288.40 / $478.63
| Facility | | $181.97 | $288.40 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $6,025.60 / $10,715.19
| Facility | | $2,691.53 | $6,025.60 | $10,715.19 |