- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.63 / $372.55 / $2,168.00
| Facility | | $295.63 | $372.55 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.42 / $8,328.96 / $18,388.59
| Facility | | $627.42 | $8,328.96 | $18,388.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $947.55 / $1,343.74 / $3,232.55
| Facility | | $947.55 | $1,343.74 | $3,232.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $770.29 / $1,228.50 / $2,545.31
| Facility | | $770.29 | $1,228.50 | $2,545.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.11 / $629.61 / $4,746.00
| Facility | | $465.11 | $629.61 | $4,746.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |