- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $3,890.45 / $7,244.36
| Facility | | $218.78 | $3,890.45 | $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
- $154.88 / $154.88 / $154.88
| Facility | | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $549.54 / $1,380.38
| Facility | | $257.04 | $549.54 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $5,623.41 / $10,715.19
| Facility | | $1,862.09 | $5,623.41 | $10,715.19 |