- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,511.89 / $7,585.78
| Facility | | $630.96 | $2,511.89 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,890.45 / $8,511.38
| Facility | | $1,023.29 | $3,890.45 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $104.71 / $107.15
| Facility | | $79.43 | $104.71 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $758.58
| Facility | | $54.95 | $56.23 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $1,000.00 / $5,128.61
| Facility | | $125.89 | $1,000.00 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $144.54 / $239.88
| Facility | | $109.65 | $144.54 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $1,047.13 / $2,691.53
| Facility | | $158.49 | $1,047.13 | $2,691.53 |