- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.59 / $3,814.77 / $12,765.09
| Facility | | $160.59 | $3,814.77 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,226.25 / $3,017.14 / $5,663.95
| Facility | | $2,226.25 | $3,017.14 | $5,663.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.27 / $235.04 / $1,315.00
| Facility | | $136.27 | $235.04 | $1,315.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.85 / $266.08 / $391.24
| Facility | | $199.85 | $266.08 | $391.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,056.00 / $1,527.00 / $4,317.00
| Facility | | $1,056.00 | $1,527.00 | $4,317.00 |