- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.02 / $787.00 / $3,740.00
| Facility | | $272.02 | $787.00 | $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
- $298.30 / $424.17 / $489.31
| Facility | | $298.30 | $424.17 | $489.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.19 / $377.19 / $676.55
| Facility | | $377.19 | $377.19 | $676.55 |
- 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 |