- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,691.53 / $7,585.78
| Facility | | $1,819.70 | $2,691.53 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $151.36 / $1,621.81
| Facility | | $109.65 | $151.36 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $12,302.69
| Facility | | $12,302.69 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $1,288.25 / $1,288.25
| Facility | | $54.95 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $812.83 / $15,488.17
| Facility | | $295.12 | $812.83 | $15,488.17 |