- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.52 / $421.52 / $3,506.00
| Facility | | $421.52 | $421.52 | $3,506.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.43 / $2,074.00 / $13,600.63
| Facility | | $816.43 | $2,074.00 | $13,600.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $927.33 / $1,315.07 / $3,163.59
| Facility | | $927.33 | $1,315.07 | $3,163.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $753.85 / $1,202.29 / $2,491.01
| Facility | | $753.85 | $1,202.29 | $2,491.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $662.20 / $771.66 / $3,954.00
| Facility | | $662.20 | $771.66 | $3,954.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |