- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.33 / $491.93 / $2,747.00
| Facility | | $212.33 | $491.93 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,014.00 / $8,584.00 / $11,253.00
| Facility | | $4,014.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.01 / $331.10 / $381.96
| Facility | | $227.01 | $331.10 | $381.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.55 / $435.16 / $435.16
| Facility | | $265.55 | $435.16 | $435.16 |
- 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 |