- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.66 / $642.76 / $2,168.00
| Facility | | $144.66 | $642.76 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.04 / $1,074.58 / $2,427.64
| Facility | | $340.04 | $1,074.58 | $2,427.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,345.85 / $2,257.48 / $5,430.68
| Facility | | $1,345.85 | $2,257.48 | $5,430.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,253.45 / $1,990.36 / $4,276.13
| Facility | | $1,253.45 | $1,990.36 | $4,276.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.76 / $572.72 / $1,587.90
| Facility | | $198.76 | $572.72 | $1,587.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,755.00 / $2,872.00 / $4,241.00
| Facility | | $1,755.00 | $2,872.00 | $4,241.00 |