- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,288.25 / $5,370.32
| Facility | | $501.19 | $1,288.25 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $933.25 / $2,511.89
| Facility | | $0.02 | $933.25 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $309.03 / $309.03
| Facility | | $39.81 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $5,888.44 / $5,888.44
| Facility | | $5,888.44 | $5,888.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $512.86 / $1,995.26
| Facility | | $208.93 | $512.86 | $1,995.26 |