- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.86 / $346.65 / $2,168.00
| Facility | | $274.86 | $346.65 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.32 / $8,328.96 / $18,388.59
| Facility | | $584.32 | $8,328.96 | $18,388.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $878.48 / $1,245.80 / $2,996.93
| Facility | | $878.48 | $1,245.80 | $2,996.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.14 / $1,138.96 / $2,359.79
| Facility | | $714.14 | $1,138.96 | $2,359.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.67 / $585.84 / $3,307.00
| Facility | | $428.67 | $585.84 | $3,307.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,296.00 / $3,500.00 / $6,361.00
| Facility | | $2,296.00 | $3,500.00 | $6,361.00 |