- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.18 / $896.00 / $8,229.00
| Facility | | $326.18 | $896.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,320.00 / $4,261.00 / $11,433.00
| Facility | | $2,320.00 | $4,261.00 | $11,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $359.31 / $505.60 / $583.24
| Facility | | $359.31 | $505.60 | $583.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.30 / $450.48 / $450.48
| Facility | | $381.30 | $450.48 | $450.48 |
- 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 |