- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $426.58 / $6,309.57
| Facility | | $204.17 | $426.58 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,238.72 / $5,370.32
| Facility | | $537.03 | $2,238.72 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,584.89 / $3,890.45
| Facility | | $1,000.00 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,445.44 / $3,090.30
| Facility | | $1,230.27 | $1,445.44 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $537.03 / $1,288.25
| Facility | | $245.47 | $537.03 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,019.95 / $6,456.54
| Facility | | $1,445.44 | $3,019.95 | $6,456.54 |