- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.83 / $787.00 / $3,740.00
| Facility | | $357.83 | $787.00 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,014.00 / $8,584.00 / $11,253.00
| Facility | | $4,014.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.05 / $543.07 / $626.47
| Facility | | $385.05 | $543.07 | $626.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.38 / $498.09 / $498.09
| Facility | | $404.38 | $498.09 | $498.09 |
- 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 |