- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $147.91 / $2,238.72
| Facility | | $147.91 | $147.91 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $977.24 / $2,344.23
| Facility | | $1.00 | $977.24 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $549.54 / $1,318.26
| Facility | | $389.05 | $549.54 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $537.03 / $1,047.13
| Facility | | $426.58 | $537.03 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $309.03 / $2,398.83
| Facility | | $147.91 | $309.03 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,862.09 / $3,715.35
| Facility | | $1,096.48 | $1,862.09 | $3,715.35 |