- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $3,801.89 / $5,623.41
| Facility | | $85.11 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $8,317.64
| Facility | | $1,995.26 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $74.13 / $83.18
| Facility | | $70.79 | $74.13 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $676.08
| Facility | | $123.03 | $123.03 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,715.35 / $6,456.54
| Facility | | $794.33 | $3,715.35 | $6,456.54 |