- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.46 / $765.75 / $2,168.00
| Facility | | $198.46 | $765.75 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $163.55 / $1,713.52
| Facility | | $0.98 | $163.55 | $1,713.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,816.67 / $2,577.59 / $6,200.74
| Facility | | $1,816.67 | $2,577.59 | $6,200.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,477.58 / $2,356.54 / $4,882.47
| Facility | | $1,477.58 | $2,356.54 | $4,882.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.31 / $733.72 / $1,931.19
| Facility | | $267.31 | $733.72 | $1,931.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |