- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.91 / $750.04 / $3,740.00
| Facility | | $226.91 | $750.04 | $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
- $246.28 / $352.35 / $406.47
| Facility | | $246.28 | $352.35 | $406.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.26 / $307.26 / $413.10
| Facility | | $307.26 | $307.26 | $413.10 |
- 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 |