- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $3,981.07 / $15,135.61
| Facility | | $173.78 | $3,981.07 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $9,120.11 / $11,220.18
| Facility | | $3,019.95 | $9,120.11 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $162.18 / $190.55
| Facility | | $109.65 | $162.18 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $218.78 / $218.78
| Facility | | $34.67 | $218.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,466.84 / $30,199.52
| Facility | | $602.56 | $4,466.84 | $30,199.52 |