- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.31 / $330.49 / $2,384.00
| Facility | | $155.31 | $330.49 | $2,384.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.69 / $3,244.31 / $7,034.84
| Facility | | $338.69 | $3,244.31 | $7,034.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $719.21 / $1,206.38 / $2,902.11
| Facility | | $719.21 | $1,206.38 | $2,902.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.83 / $1,100.90 / $2,285.13
| Facility | | $669.83 | $1,100.90 | $2,285.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.36 / $454.10 / $1,012.51
| Facility | | $202.36 | $454.10 | $1,012.51 |
- 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 |