- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.15 / $1,484.02 / $2,906.05
| Facility | | $98.15 | $1,484.02 | $2,906.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,525.53 / $3,054.30 / $5,691.54
| Facility | | $1,525.53 | $3,054.30 | $5,691.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.83 / $311.75 / $749.95
| Facility | | $219.83 | $311.75 | $749.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.71 / $285.01 / $590.51
| Facility | | $178.71 | $285.01 | $590.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.94 / $510.76 / $3,745.58
| Facility | | $156.94 | $510.76 | $3,745.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,755.00 / $2,872.00 / $4,241.00
| Facility | | $1,755.00 | $2,872.00 | $4,241.00 |