- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,659.59 / $4,168.69
| Facility | | $645.65 | $1,659.59 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $17,378.01 / $39,810.72
| Facility | | $8,128.31 | $17,378.01 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $302.00
| Facility | | $39.81 | $39.81 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $5,370.32 / $22,387.21
| Facility | | $1,148.15 | $5,370.32 | $22,387.21 |