- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.01 / $582.76 / $2,525.00
| Facility | | $369.01 | $582.76 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.58 / $4,844.72 / $10,098.06
| Facility | | $711.58 | $4,844.72 | $10,098.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,431.11 / $2,030.54 / $4,884.74
| Facility | | $1,431.11 | $2,030.54 | $4,884.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,253.41 / $1,856.40 / $3,846.25
| Facility | | $1,253.41 | $1,856.40 | $3,846.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.81 / $764.05 / $1,601.73
| Facility | | $370.81 | $764.05 | $1,601.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |