- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,170.00 / $3,055.00 / $7,960.15
| Facility | | $1,170.00 | $3,055.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.79 / $2,362.71 / $4,140.09
| Facility | | $632.79 | $2,362.71 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.35 / $299.32 / $490.43
| Facility | | $226.35 | $299.32 | $490.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.95 / $379.77 / $810.06
| Facility | | $244.95 | $379.77 | $810.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.00 / $2,567.00 / $4,466.00
| Facility | | $966.00 | $2,567.00 | $4,466.00 |