- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.31 / $3,801.89 / $5,623.41
| Facility | | $36.31 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,125.38 / $19,054.61
| Facility | | $6,456.54 | $14,125.38 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.90 / $34.67 / $36.31
| Facility | | $30.90 | $34.67 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $52.48 / $77.62
| Facility | | $33.88 | $52.48 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $15,848.93 / $23,442.29
| Facility | | $9,120.11 | $15,848.93 | $23,442.29 |