- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.39 / $255.83 / $2,042.00
| Facility | | $95.39 | $255.83 | $2,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.37 / $2,993.28 / $6,762.24
| Facility | | $487.37 | $2,993.28 | $6,762.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.29 / $928.08 / $2,232.61
| Facility | | $553.29 | $928.08 | $2,232.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.23 / $818.26 / $1,757.96
| Facility | | $477.23 | $818.26 | $1,757.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.71 / $306.11 / $747.51
| Facility | | $138.71 | $306.11 | $747.51 |
- 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 |