- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.78 / $560.46 / $5,634.00
| Facility | | $28.78 | $560.46 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,677.00 / $5,445.00
| Facility | | $1,636.00 | $3,677.00 | $5,445.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.59 / $41.25 / $65.18
| Facility | | $28.59 | $41.25 | $65.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.79 / $172.79 / $204.82
| Facility | | $172.79 | $172.79 | $204.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $866.00 / $2,291.00 / $4,426.00
| Facility | | $866.00 | $2,291.00 | $4,426.00 |