- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.96 / $746.66 / $4,557.00
| Facility | | $188.96 | $746.66 | $4,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,324.72 / $2,818.94 / $5,761.70
| Facility | | $1,324.72 | $2,818.94 | $5,761.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,593.65 / $2,673.15 / $6,430.61
| Facility | | $1,593.65 | $2,673.15 | $6,430.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,374.58 / $2,356.84 / $5,063.47
| Facility | | $1,374.58 | $2,356.84 | $5,063.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.44 / $708.19 / $2,156.98
| Facility | | $243.44 | $708.19 | $2,156.98 |
- 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 |