- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $5,370.32 / $6,025.60
| Facility | | $199.53 | $5,370.32 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,754.40 / $15,135.61
| Facility | | $3,235.94 | $5,754.40 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $812.83 / $1,905.46
| Facility | | $575.44 | $812.83 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $776.25 / $1,513.56
| Facility | | $616.60 | $776.25 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $575.44 / $7,585.78
| Facility | | $269.15 | $575.44 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $8,912.51
| Facility | | $2,884.03 | $5,248.07 | $8,912.51 |