- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $805.43 / $5,000.27 / $7,838.38
| Facility | | $805.43 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,953.67 / $9,743.10 / $15,889.72
| Facility | | $3,953.67 | $9,743.10 | $15,889.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.28 / $330.28 / $3,270.85
| Facility | | $330.28 | $330.28 | $3,270.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.08 / $507.28 / $1,026.67
| Facility | | $185.08 | $507.28 | $1,026.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $6,599.00 / $7,158.00
| Facility | | $936.00 | $6,599.00 | $7,158.00 |