- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $295.12 / $2,137.96
| Facility | | $151.36 | $295.12 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,630.27 / $4,168.69
| Facility | | $1,698.24 | $2,630.27 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $1,122.02
| Facility | | $154.88 | $154.88 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $416.87 / $1,548.82
| Facility | | $138.04 | $416.87 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $616.60 / $1,659.59
| Facility | | $138.04 | $616.60 | $1,659.59 |