- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.61 / $383.58 / $2,168.00
| Facility | | $304.61 | $383.58 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.27 / $5,677.23 / $12,389.06
| Facility | | $647.27 | $5,677.23 | $12,389.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.18 / $1,384.35 / $3,330.24
| Facility | | $976.18 | $1,384.35 | $3,330.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $793.57 / $1,265.63 / $2,622.24
| Facility | | $793.57 | $1,265.63 | $2,622.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.82 / $648.25 / $3,307.00
| Facility | | $485.82 | $648.25 | $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 |