- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.80 / $8,477.27 / $20,928.72
| Facility | | $67.80 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,973.60 / $6,541.64 / $12,653.65
| Facility | | $4,973.60 | $6,541.64 | $12,653.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.54 / $912.54 / $912.54
| Facility | | $912.54 | $912.54 | $912.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.80 / $128.82 / $1,483.18
| Facility | | $67.80 | $128.82 | $1,483.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.76 / $180.28 / $1,163.35
| Facility | | $127.76 | $180.28 | $1,163.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |