- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,290.87 / $7,585.78
| Facility | | $575.44 | $2,290.87 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,754.23 / $3,801.89
| Facility | | $1,288.25 | $2,754.23 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $1,023.29 / $1,949.84
| Facility | | $263.03 | $1,023.29 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $4,897.79
| Facility | | $54.95 | $56.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,187.76 / $3,981.07
| Facility | | $1,023.29 | $2,187.76 | $3,981.07 |