- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.10 / $887.85 / $3,872.99
| Facility | | $179.10 | $887.85 | $3,872.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,430.36 / $2,891.53 / $5,761.70
| Facility | | $1,430.36 | $2,891.53 | $5,761.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,877.78 / $3,149.73 / $7,577.09
| Facility | | $1,877.78 | $3,149.73 | $7,577.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,619.65 / $2,777.02 / $5,966.21
| Facility | | $1,619.65 | $2,777.02 | $5,966.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.11 / $887.85 / $2,532.42
| Facility | | $239.11 | $887.85 | $2,532.42 |
- 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 |