- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.22 / $194.24 / $2,042.00
| Facility | | $53.22 | $194.24 | $2,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.32 / $1,425.97 / $3,221.46
| Facility | | $267.32 | $1,425.97 | $3,221.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $423.69 / $710.69 / $1,709.66
| Facility | | $423.69 | $710.69 | $1,709.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.45 / $626.59 / $1,346.19
| Facility | | $365.45 | $626.59 | $1,346.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.06 / $172.29 / $584.26
| Facility | | $72.06 | $172.29 | $584.26 |
- 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 |