- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.28 / $731.00 / $7,212.00
| Facility | | $226.28 | $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
- $219.18 / $319.25 / $506.61
| Facility | | $219.18 | $319.25 | $506.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.96 / $439.96 / $439.96
| Facility | | $439.96 | $439.96 | $439.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.00 / $2,252.00 / $4,426.00
| Facility | | $933.00 | $2,252.00 | $4,426.00 |