- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $1,949.84 / $7,762.47
| Facility | | $275.42 | $1,949.84 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,570.88 / $7,413.10
| Facility | | $2,089.30 | $4,570.88 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $1,659.59
| Facility | | $331.13 | $331.13 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $239.88 / $467.74
| Facility | | $181.97 | $239.88 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,467.37 / $12,022.64
| Facility | | $562.34 | $3,467.37 | $12,022.64 |