- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.31 / $6,187.17 / $12,264.37
| Facility | | $487.31 | $6,187.17 | $12,264.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,112.75 / $4,464.22 / $8,009.20
| Facility | | $2,112.75 | $4,464.22 | $8,009.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $2,130.29 / $2,737.46
| Facility | | $505.00 | $2,130.29 | $2,737.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.20 / $253.00 / $415.74
| Facility | | $170.20 | $253.00 | $415.74 |
- 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 |