- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $3,090.30 / $8,912.51
| Facility | | $467.74 | $3,090.30 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,630.27 / $7,244.36
| Facility | | $954.99 | $2,630.27 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $257.04 / $1,096.48
| Facility | | $229.09 | $257.04 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $616.60 / $1,659.59
| Facility | | $407.38 | $616.60 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,202.26 / $3,548.13
| Facility | | $407.38 | $1,202.26 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $2,344.23
| Facility | | $100.00 | $100.00 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,398.83 / $5,248.07
| Facility | | $676.08 | $2,398.83 | $5,248.07 |