- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $1,949.84 / $9,120.11
| Facility | | $204.17 | $1,949.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,073.80 / $9,549.93
| Facility | | $2,187.76 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $141.25 / $1,174.90
| Facility | | $112.20 | $141.25 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $2,511.89
| Facility | | $208.93 | $208.93 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $602.56 / $3,162.28
| Facility | | $50.12 | $602.56 | $3,162.28 |