- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.79 / $2,838.15 / $15,652.16
| Facility | | $252.79 | $2,838.15 | $15,652.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,863.89 / $4,708.31 / $8,041.18
| Facility | | $1,863.89 | $4,708.31 | $8,041.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $2,106.17 / $2,706.47
| Facility | | $505.00 | $2,106.17 | $2,706.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.33 / $290.70 / $439.67
| Facility | | $191.33 | $290.70 | $439.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |