- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $851.14 / $4,265.80
| Facility | | $169.82 | $851.14 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $1,659.59 / $2,570.40
| Facility | | $1.00 | $1,659.59 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $3,162.28 / $7,413.10
| Facility | | $2,238.72 | $3,162.28 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,019.95 / $5,888.44
| Facility | | $2,398.83 | $3,019.95 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $933.25 / $2,344.23
| Facility | | $234.42 | $933.25 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,862.09 / $3,715.35
| Facility | | $1,096.48 | $1,862.09 | $3,715.35 |