- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.80 / $5,000.27 / $7,838.38
| Facility | | $375.80 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,896.65 / $4,673.95 / $7,622.60
| Facility | | $1,896.65 | $4,673.95 | $7,622.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.38 / $282.38 / $1,023.75
| Facility | | $282.38 | $282.38 | $1,023.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.15 / $307.86 / $487.84
| Facility | | $158.15 | $307.86 | $487.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.00 / $3,085.00 / $5,060.00
| Facility | | $755.00 | $3,085.00 | $5,060.00 |