- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.50 / $588.05 / $5,320.00
| Facility | | $296.50 | $588.05 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,389.00
| Facility | | $1,258.00 | $2,316.00 | $4,389.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.08 / $464.25 / $535.54
| Facility | | $326.08 | $464.25 | $535.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.99 / $610.16 / $610.16
| Facility | | $495.99 | $610.16 | $610.16 |
- 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 |