- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.20 / $394.43 / $2,168.00
| Facility | | $318.20 | $394.43 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.00 / $15,157.95 / $32,738.65
| Facility | | $676.00 | $15,157.95 | $32,738.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,004.82 / $1,424.96 / $3,427.94
| Facility | | $1,004.82 | $1,424.96 | $3,427.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.85 / $1,302.76 / $2,699.16
| Facility | | $816.85 | $1,302.76 | $2,699.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.93 / $670.43 / $3,307.00
| Facility | | $499.93 | $670.43 | $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 |