- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.42 / $578.12 / $3,740.00
| Facility | | $384.42 | $578.12 | $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
- $420.35 / $599.07 / $691.07
| Facility | | $420.35 | $599.07 | $691.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.20 / $787.35 / $787.35
| Facility | | $488.20 | $787.35 | $787.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $668.00 / $3,176.00
| Facility | | $50.00 | $668.00 | $3,176.00 |