- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.84 / $596.16 / $5,320.00
| Facility | | $440.84 | $596.16 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,229.00
| Facility | | $1,258.00 | $2,316.00 | $4,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.93 / $646.37 / $745.64
| Facility | | $470.93 | $646.37 | $745.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $849.51 / $849.51 / $849.51
| Facility | | $849.51 | $849.51 | $849.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,450.00 / $5,301.00
| Facility | | $523.00 | $1,450.00 | $5,301.00 |