- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $691.83 / $4,897.79
| Facility | | $104.71 | $691.83 | $4,897.79 |
- 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
- $87.10 / $95.50 / $107.15
| Facility | | $87.10 | $95.50 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $128.82 / $239.88
| Facility | | $100.00 | $128.82 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $2,137.96 / $5,754.40
| Facility | | $199.53 | $2,137.96 | $5,754.40 |