- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.13 / $153.13 / $2,168.00
| Facility | | $153.13 | $153.13 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.01 / $1,738.32 / $4,265.76
| Facility | | $712.01 | $1,738.32 | $4,265.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.40 / $557.79 / $1,341.87
| Facility | | $357.40 | $557.79 | $1,341.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.70 / $509.03 / $1,056.58
| Facility | | $309.70 | $509.03 | $1,056.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.19 / $275.45 / $1,227.90
| Facility | | $159.19 | $275.45 | $1,227.90 |
- 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 |