- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.64 / $367.17 / $4,828.00
| Facility | | $238.64 | $367.17 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $469.37 / $3,057.02 / $6,480.74
| Facility | | $469.37 | $3,057.02 | $6,480.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $927.33 / $1,315.07 / $3,163.59
| Facility | | $927.33 | $1,315.07 | $3,163.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $753.85 / $1,202.29 / $2,491.01
| Facility | | $753.85 | $1,202.29 | $2,491.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.32 / $470.54 / $978.89
| Facility | | $282.32 | $470.54 | $978.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |