- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.64 / $731.00 / $7,212.00
| Facility | | $227.64 | $731.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,804.00 / $4,353.00 / $8,052.00
| Facility | | $1,804.00 | $4,353.00 | $8,052.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.82 / $323.10 / $547.91
| Facility | | $221.82 | $323.10 | $547.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.05 / $506.05 / $506.05
| Facility | | $506.05 | $506.05 | $506.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $2,854.00 / $4,271.00
| Facility | | $1,638.00 | $2,854.00 | $4,271.00 |