- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.03 / $310.05 / $3,638.00
| Facility | | $177.03 | $310.05 | $3,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $824.78 / $2,831.53 / $6,031.72
| Facility | | $824.78 | $2,831.53 | $6,031.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $726.03 / $1,029.59 / $2,476.85
| Facility | | $726.03 | $1,029.59 | $2,476.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.21 / $941.30 / $1,950.28
| Facility | | $590.21 | $941.30 | $1,950.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.56 / $511.58 / $2,523.00
| Facility | | $279.56 | $511.58 | $2,523.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,296.00 / $3,500.00 / $6,361.00
| Facility | | $2,296.00 | $3,500.00 | $6,361.00 |