- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.49 / $1,987.64 / $8,644.04
| Facility | | $269.49 | $1,987.64 | $8,644.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.65 / $5,890.92 / $13,308.42
| Facility | | $1,230.65 | $5,890.92 | $13,308.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.64 / $888.66 / $2,137.79
| Facility | | $626.64 | $888.66 | $2,137.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.42 / $812.45 / $1,683.30
| Facility | | $509.42 | $812.45 | $1,683.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.89 / $533.94 / $6,740.00
| Facility | | $393.89 | $533.94 | $6,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |