- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $4,570.88 / $9,332.54
| Facility | | $131.83 | $4,570.88 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,466.84 / $8,709.64
| Facility | | $2,454.71 | $4,466.84 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $104.71 / $117.49
| Facility | | $100.00 | $104.71 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $169.82 / $251.19
| Facility | | $114.82 | $169.82 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $2,137.96 / $5,754.40
| Facility | | $331.13 | $2,137.96 | $5,754.40 |