- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $1,513.56 / $5,495.41
| Facility | | $162.18 | $1,513.56 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,715.19 / $11,220.18
| Facility | | $9,549.93 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $154.88 / $199.53
| Facility | | $109.65 | $154.88 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $208.93 / $208.93
| Facility | | $34.67 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $602.56 / $3,162.28
| Facility | | $50.12 | $602.56 | $3,162.28 |