- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.78 / $637.00 / $8,229.00
| Facility | | $223.78 | $637.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $8,517.00
| Facility | | $1,643.00 | $3,498.00 | $8,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $220.74 / $302.22 / $348.63
| Facility | | $220.74 | $302.22 | $348.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.52 / $265.52 / $337.72
| Facility | | $265.52 | $265.52 | $337.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,853.00 / $8,582.00
| Facility | | $739.00 | $3,853.00 | $8,582.00 |