- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.86 / $184.86 / $2,525.00
| Facility | | $184.86 | $184.86 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $844.78 / $2,796.20 / $5,711.66
| Facility | | $844.78 | $2,796.20 | $5,711.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.06 / $641.41 / $1,543.00
| Facility | | $452.06 | $641.41 | $1,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.97 / $586.40 / $1,214.96
| Facility | | $410.97 | $586.40 | $1,214.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.34 / $317.50 / $2,296.00
| Facility | | $186.34 | $317.50 | $2,296.00 |
- 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 |