- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.37 / $147.37 / $2,168.00
| Facility | | $147.37 | $147.37 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $126.70 / $1,386.25
| Facility | | $0.98 | $126.70 | $1,386.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.60 / $525.54 / $1,264.29
| Facility | | $370.60 | $525.54 | $1,264.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.27 / $480.48 / $995.50
| Facility | | $301.27 | $480.48 | $995.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.16 / $293.63 / $1,966.00
| Facility | | $207.16 | $293.63 | $1,966.00 |
- 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 |