- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.08 / $134.55 / $2,168.00
| Facility | | $67.08 | $134.55 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $297.02 / $979.42
| Facility | | $1.00 | $297.02 | $979.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.61 / $639.02 / $1,537.26
| Facility | | $450.61 | $639.02 | $1,537.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.31 / $584.22 / $1,210.44
| Facility | | $366.31 | $584.22 | $1,210.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.99 / $303.07 / $1,727.00
| Facility | | $210.99 | $303.07 | $1,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,063.00 / $1,597.44 / $3,584.00
| Facility | | $1,063.00 | $1,597.44 | $3,584.00 |