- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $1,122.02 / $7,762.47
| Facility | | $199.53 | $1,122.02 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,235.94 / $5,248.07
| Facility | | $1,479.11 | $3,235.94 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $1,023.29
| Facility | | $245.47 | $245.47 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $707.95 / $1,659.59
| Facility | | $144.54 | $707.95 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,467.37 / $8,317.64
| Facility | | $562.34 | $3,467.37 | $8,317.64 |