- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.06 / $268.12 / $2,168.00
| Facility | | $116.06 | $268.12 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,036.15 / $1,696.48 / $3,237.96
| Facility | | $1,036.15 | $1,696.48 | $3,237.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $589.28 / $919.72 / $2,212.50
| Facility | | $589.28 | $919.72 | $2,212.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.66 / $810.89 / $1,742.13
| Facility | | $510.66 | $810.89 | $1,742.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.97 / $306.70 / $674.30
| Facility | | $145.97 | $306.70 | $674.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,755.00 / $2,872.00 / $4,241.00
| Facility | | $1,755.00 | $2,872.00 | $4,241.00 |