- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $3,801.89 / $5,623.41
| Facility | | $66.07 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,265.80 / $8,709.64
| Facility | | $2,187.76 | $4,265.80 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $61.66 / $66.07
| Facility | | $56.23 | $61.66 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $109.65 / $173.78
| Facility | | $60.26 | $109.65 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $2,137.96 / $5,754.40
| Facility | | $331.13 | $2,137.96 | $5,754.40 |