- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.57 / $2,747.00 / $5,270.00
| Facility | | $243.57 | $2,747.00 | $5,270.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.87 / $1,117.67 / $3,804.00
| Facility | | $553.87 | $1,117.67 | $3,804.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $797.74 / $950.07 / $1,228.82
| Facility | | $797.74 | $950.07 | $1,228.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.41 / $1,367.15 / $2,047.94
| Facility | | $606.41 | $1,367.15 | $2,047.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $365.63 / $6,679.00
| Facility | | $214.32 | $365.63 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,430.00 / $7,161.00
| Facility | | $1,106.00 | $2,430.00 | $7,161.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |