- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $2,818.38 / $8,511.38
| Facility | | $234.42 | $2,818.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $10,715.19 / $15,135.61
| Facility | | $8,912.51 | $10,715.19 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $257.04 / $354.81
| Facility | | $208.93 | $257.04 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $407.38 / $407.38
| Facility | | $34.67 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $10,000.00
| Facility | | $724.44 | $2,511.89 | $10,000.00 |