- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.10 / $145.10 / $2,469.53
| Facility | | $145.10 | $145.10 | $2,469.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.31 / $3,084.88 / $6,762.24
| Facility | | $1,300.31 | $3,084.88 | $6,762.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.03 / $529.13 / $1,272.91
| Facility | | $339.03 | $529.13 | $1,272.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.80 / $482.87 / $1,002.29
| Facility | | $293.80 | $482.87 | $1,002.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.11 / $289.33 / $2,296.00
| Facility | | $148.11 | $289.33 | $2,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $3,500.00 / $6,361.00
| Facility | | $1,224.00 | $3,500.00 | $6,361.00 |