- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $1,412.54 / $7,762.47
| Facility | | $165.96 | $1,412.54 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,951.21 / $4,897.79
| Facility | | $707.95 | $2,951.21 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $1,023.29
| Facility | | $199.53 | $199.53 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $223.87 / $1,513.56
| Facility | | $117.49 | $223.87 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,467.37 / $8,317.64
| Facility | | $562.34 | $3,467.37 | $8,317.64 |