- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.31 / $1,471.36 / $7,278.00
| Facility | | $232.31 | $1,471.36 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.70 / $843.36 / $1,431.16
| Facility | | $766.70 | $843.36 | $1,431.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.41 / $887.89 / $1,675.01
| Facility | | $338.41 | $887.89 | $1,675.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.31 / $1,038.72 / $1,961.84
| Facility | | $232.31 | $1,038.72 | $1,961.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,353.85 / $1,353.85
| Facility | | $55.00 | $1,353.85 | $1,353.85 |