- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.92 / $426.31 / $2,168.00
| Facility | | $206.92 | $426.31 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.58 / $1,918.16 / $4,193.72
| Facility | | $451.58 | $1,918.16 | $4,193.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $991.83 / $1,514.30 / $3,723.89
| Facility | | $991.83 | $1,514.30 | $3,723.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.51 / $1,273.97 / $2,932.20
| Facility | | $859.51 | $1,273.97 | $2,932.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.24 / $621.15 / $1,267.74
| Facility | | $297.24 | $621.15 | $1,267.74 |
- 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 |