- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.75 / $731.00 / $7,212.00
| Facility | | $267.75 | $731.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $5,126.00 / $8,240.00
| Facility | | $2,234.00 | $5,126.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.39 / $380.73 / $594.26
| Facility | | $261.39 | $380.73 | $594.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,314.83 / $1,314.83 / $1,314.83
| Facility | | $1,314.83 | $1,314.83 | $1,314.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $3,870.00 / $5,490.00
| Facility | | $2,400.00 | $3,870.00 | $5,490.00 |