- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.04 / $190.73 / $2,525.00
| Facility | | $123.04 | $190.73 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.93 / $660.82 / $1,417.07
| Facility | | $299.93 | $660.82 | $1,417.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $483.46 / $685.61 / $1,649.32
| Facility | | $483.46 | $685.61 | $1,649.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.02 / $626.80 / $1,298.68
| Facility | | $393.02 | $626.80 | $1,298.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.90 / $251.83 / $511.23
| Facility | | $149.90 | $251.83 | $511.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,749.00 / $2,883.00
| Facility | | $563.00 | $1,749.00 | $2,883.00 |