- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.68 / $308.51 / $4,557.00
| Facility | | $146.68 | $308.51 | $4,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,706.64 / $5,572.33 / $10,098.06
| Facility | | $2,706.64 | $5,572.33 | $10,098.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $744.18 / $1,055.88 / $2,540.06
| Facility | | $744.18 | $1,055.88 | $2,540.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.27 / $965.33 / $2,000.05
| Facility | | $605.27 | $965.33 | $2,000.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.86 / $345.53 / $894.05
| Facility | | $181.86 | $345.53 | $894.05 |
- 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 |