- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $354.81 / $1,318.26
| Facility | | $158.49 | $354.81 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,089.30 / $4,073.80
| Facility | | $954.99 | $2,089.30 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,288.25 / $3,090.30
| Facility | | $812.83 | $1,288.25 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,230.27 / $2,398.83
| Facility | | $1,000.00 | $1,230.27 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $389.05 / $1,737.80
| Facility | | $173.78 | $389.05 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $2,238.72 / $4,265.80
| Facility | | $977.24 | $2,238.72 | $4,265.80 |