- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.07 / $557.00 / $5,320.00
| Facility | | $164.07 | $557.00 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,066.00 / $2,045.00 / $2,978.00
| Facility | | $1,066.00 | $2,045.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.14 / $225.43 / $263.19
| Facility | | $185.14 | $225.43 | $263.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.48 / $223.48 / $238.09
| Facility | | $223.48 | $223.48 | $238.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $1,895.00
| Facility | | $50.00 | $597.00 | $1,895.00 |