- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.76 / $278.41 / $2,384.00
| Facility | | $144.76 | $278.41 | $2,384.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.82 / $888.64 / $1,611.28
| Facility | | $517.82 | $888.64 | $1,611.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $598.87 / $1,004.52 / $2,416.51
| Facility | | $598.87 | $1,004.52 | $2,416.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.54 / $885.66 / $1,902.76
| Facility | | $516.54 | $885.66 | $1,902.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.71 / $311.22 / $786.16
| Facility | | $163.71 | $311.22 | $786.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.00 / $1,727.00 / $2,883.00
| Facility | | $133.00 | $1,727.00 | $2,883.00 |