- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.26 / $291.04 / $2,168.00
| Facility | | $114.26 | $291.04 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.04 / $3,675.96 / $8,304.51
| Facility | | $502.04 | $3,675.96 | $8,304.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.84 / $937.63 / $2,255.60
| Facility | | $660.84 | $937.63 | $2,255.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.61 / $857.22 / $1,776.06
| Facility | | $520.61 | $857.22 | $1,776.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.04 / $291.04 / $816.52
| Facility | | $119.04 | $291.04 | $816.52 |
- 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 |