- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.64 / $305.43 / $2,042.00
| Facility | | $303.64 | $305.43 | $2,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.48 / $778.05 / $2,613.48
| Facility | | $306.48 | $778.05 | $2,613.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $747.55 / $1,060.66 / $2,551.56
| Facility | | $747.55 | $1,060.66 | $2,551.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.59 / $969.70 / $2,009.10
| Facility | | $679.59 | $969.70 | $2,009.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.43 / $539.89 / $875.49
| Facility | | $305.43 | $539.89 | $875.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,438.00 / $2,883.00
| Facility | | $382.00 | $1,438.00 | $2,883.00 |