- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.73 / $342.22 / $2,376.36
| Facility | | $185.73 | $342.22 | $2,376.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.76 / $4,512.21 / $9,603.34
| Facility | | $2,088.76 | $4,512.21 | $9,603.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.04 / $1,177.71 / $2,833.15
| Facility | | $830.04 | $1,177.71 | $2,833.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.11 / $1,076.71 / $2,230.83
| Facility | | $675.11 | $1,076.71 | $2,230.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.21 / $457.37 / $914.75
| Facility | | $225.21 | $457.37 | $914.75 |
- 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 |