- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.27 / $582.00 / $2,747.00
| Facility | | $288.27 | $582.00 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,066.00
| Facility | | $1,258.00 | $2,316.00 | $4,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.58 / $445.20 / $513.57
| Facility | | $308.58 | $445.20 | $513.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.17 / $585.12 / $585.12
| Facility | | $382.17 | $585.12 | $585.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.00 / $950.00 / $3,394.00
| Facility | | $391.00 | $950.00 | $3,394.00 |