- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.81 / $3,908.01 / $13,841.56
| Facility | | $157.81 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.14 / $781.45 / $1,511.58
| Facility | | $594.14 | $781.45 | $1,511.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.60 / $299.83 / $649.32
| Facility | | $136.60 | $299.83 | $649.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.85 / $257.32 / $464.78
| Facility | | $186.85 | $257.32 | $464.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.36 / $337.66 / $4,317.00
| Facility | | $247.36 | $337.66 | $4,317.00 |