- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.78 / $603.97 / $5,320.00
| Facility | | $241.78 | $603.97 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,389.00
| Facility | | $1,258.00 | $2,316.00 | $4,389.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.41 / $381.61 / $440.21
| Facility | | $269.41 | $381.61 | $440.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.28 / $501.55 / $501.55
| Facility | | $460.28 | $501.55 | $501.55 |
- 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 |