- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.95 / $563.22 / $3,740.00
| Facility | | $348.95 | $563.22 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.17 / $444.12 / $512.34
| Facility | | $311.17 | $444.12 | $512.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.96 / $583.70 / $583.70
| Facility | | $462.96 | $583.70 | $583.70 |
- 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 |