- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.38 / $406.08 / $2,042.00
| Facility | | $123.38 | $406.08 | $2,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.17 / $2,993.28 / $6,762.24
| Facility | | $629.17 | $2,993.28 | $6,762.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $873.73 / $1,465.57 / $3,525.63
| Facility | | $873.73 | $1,465.57 | $3,525.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $753.62 / $1,292.15 / $2,776.09
| Facility | | $753.62 | $1,292.15 | $2,776.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.94 / $386.34 / $1,166.81
| Facility | | $172.94 | $386.34 | $1,166.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,623.00 / $4,746.00 / $8,812.00
| Facility | | $1,623.00 | $4,746.00 | $8,812.00 |