- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $7,244.36 / $16,595.87
| Facility | | $177.83 | $7,244.36 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $4,073.80 / $7,762.47
| Facility | | $1,548.82 | $4,073.80 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,089.30 / $2,691.53
| Facility | | $501.19 | $2,089.30 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $95.50 / $151.36
| Facility | | $66.07 | $95.50 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,760.83 / $10,471.29
| Facility | | $1,698.24 | $6,760.83 | $10,471.29 |