- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $3,467.37 / $4,897.79
| Facility | | $120.23 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $8,317.64 / $10,471.29
| Facility | | $4,265.80 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $81.28 / $93.33
| Facility | | $79.43 | $81.28 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $131.83 / $181.97
| Facility | | $83.18 | $131.83 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $5,754.40 / $12,022.64
| Facility | | $1,412.54 | $5,754.40 | $12,022.64 |