- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $2,187.76 / $8,511.38
| Facility | | $257.04 | $2,187.76 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,398.83 / $4,365.16
| Facility | | $1,479.11 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $218.78 / $257.04
| Facility | | $158.49 | $218.78 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $295.12 / $1,659.59
| Facility | | $186.21 | $295.12 | $1,659.59 |
- 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 |