- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.48 / $458.02 / $2,042.00
| Facility | | $72.48 | $458.02 | $2,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,533.65 / $2,631.94 / $5,194.88
| Facility | | $1,533.65 | $2,631.94 | $5,194.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $981.26 / $1,645.93 / $3,959.51
| Facility | | $981.26 | $1,645.93 | $3,959.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $846.37 / $1,451.17 / $3,117.73
| Facility | | $846.37 | $1,451.17 | $3,117.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.13 / $419.65 / $1,296.16
| Facility | | $104.13 | $419.65 | $1,296.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $3,307.00 / $6,275.00
| Facility | | $1,224.00 | $3,307.00 | $6,275.00 |