- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $642.99 / $2,042.00
| Facility | | $81.28 | $642.99 | $2,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,178.08 / $2,021.76 / $3,990.52
| Facility | | $1,178.08 | $2,021.76 | $3,990.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,353.68 / $2,270.62 / $5,462.29
| Facility | | $1,353.68 | $2,270.62 | $5,462.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,167.58 / $2,001.94 / $4,301.01
| Facility | | $1,167.58 | $2,001.94 | $4,301.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.04 / $630.42 / $1,797.54
| Facility | | $112.04 | $630.42 | $1,797.54 |
- 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 |