- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $3,630.78 / $8,511.38
| Facility | | $77.62 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,884.03 / $4,365.16
| Facility | | $2,089.30 | $2,884.03 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $1,071.52
| Facility | | $489.78 | $489.78 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,168.69 / $6,918.31
| Facility | | $1,698.24 | $4,168.69 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $23,988.33 / $23,988.33
| Facility | | $56.23 | $23,988.33 | $23,988.33 |