- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.06 / $787.00 / $3,740.00
| Facility | | $342.06 | $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
- $371.41 / $533.09 / $614.95
| Facility | | $371.41 | $533.09 | $614.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.30 / $471.30 / $516.69
| Facility | | $471.30 | $471.30 | $516.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |