- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.44 / $637.00 / $8,229.00
| Facility | | $201.44 | $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
- $198.30 / $271.39 / $313.06
| Facility | | $198.30 | $271.39 | $313.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.67 / $238.67 / $265.68
| Facility | | $238.67 | $238.67 | $265.68 |
- 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 |