- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.37 / $965.39 / $5,320.00
| Facility | | $142.37 | $965.39 | $5,320.00 |
- 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
- $141.04 / $193.58 / $223.31
| Facility | | $141.04 | $193.58 | $223.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.18 / $254.42 / $254.42
| Facility | | $184.18 | $254.42 | $254.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,913.00 / $5,301.00
| Facility | | $523.00 | $1,913.00 | $5,301.00 |