- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.40 / $194.94 / $2,384.00
| Facility | | $68.40 | $194.94 | $2,384.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.83 / $1,918.16 / $4,193.72
| Facility | | $528.83 | $1,918.16 | $4,193.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,393.61 / $2,175.07 / $5,232.42
| Facility | | $1,393.61 | $2,175.07 | $5,232.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,118.46 / $1,917.70 / $4,120.01
| Facility | | $1,118.46 | $1,917.70 | $4,120.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.27 / $638.27 / $1,737.37
| Facility | | $271.27 | $638.27 | $1,737.37 |
- 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 |