- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $2,290.87 / $8,511.38
| Facility | | $77.62 | $2,290.87 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,398.83 / $4,365.16
| Facility | | $1,479.11 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $81.28 / $95.50
| Facility | | $57.54 | $81.28 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $109.65 / $1,659.59
| Facility | | $109.65 | $109.65 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,445.44 / $5,248.07
| Facility | | $524.81 | $1,445.44 | $5,248.07 |