- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $1,778.28 / $3,890.45
| Facility | | $79.43 | $1,778.28 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,137.96 / $2,951.21
| Facility | | $1,258.93 | $2,137.96 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.70 / $75.86 / $89.13
| Facility | | $53.70 | $75.86 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $102.33 / $102.33
| Facility | | $34.67 | $102.33 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $602.56 / $11,220.18
| Facility | | $50.12 | $602.56 | $11,220.18 |