- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.76 / $284.76 / $3,350.00
| Facility | | $284.76 | $284.76 | $3,350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,370.08 / $4,551.30 / $9,978.29
| Facility | | $1,370.08 | $4,551.30 | $9,978.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.17 / $1,047.52 / $2,519.94
| Facility | | $671.17 | $1,047.52 | $2,519.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.63 / $955.93 / $1,984.21
| Facility | | $581.63 | $955.93 | $1,984.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.68 / $528.60 / $933.79
| Facility | | $297.68 | $528.60 | $933.79 |
- 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 |