- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.74 / $223.76 / $2,384.00
| Facility | | $90.74 | $223.76 | $2,384.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,025.04 / $4,014.27 / $6,556.52
| Facility | | $2,025.04 | $4,014.27 | $6,556.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.40 / $759.66 / $1,827.47
| Facility | | $535.40 | $759.66 | $1,827.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.47 / $694.51 / $1,438.95
| Facility | | $435.47 | $694.51 | $1,438.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.93 / $236.67 / $588.00
| Facility | | $100.93 | $236.67 | $588.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,388.00 / $3,500.00 / $6,361.00
| Facility | | $1,388.00 | $3,500.00 | $6,361.00 |