- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.82 / $753.45 / $9,727.00
| Facility | | $208.82 | $753.45 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,351.92 / $4,036.79
| Facility | | $1,000.00 | $2,351.92 | $4,036.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $1,007.90 / $1,295.17
| Facility | | $505.00 | $1,007.90 | $1,295.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.82 / $348.39 / $561.00
| Facility | | $208.82 | $348.39 | $561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |