- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.68 / $1,245.00 / $7,278.00
| Facility | | $190.68 | $1,245.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $839.45 / $923.39 / $1,566.96
| Facility | | $839.45 | $923.39 | $1,566.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.19 / $887.89 / $1,675.01
| Facility | | $222.19 | $887.89 | $1,675.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.68 / $272.24 / $340.52
| Facility | | $190.68 | $272.24 | $340.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $1,233.00 / $4,877.00
| Facility | | $400.00 | $1,233.00 | $4,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,269.38 / $6,482.70
| Facility | | $55.00 | $1,269.38 | $6,482.70 |