- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.14 / $555.21 / $3,740.00
| Facility | | $315.14 | $555.21 | $3,740.00 |
- 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
- $311.56 / $425.28 / $490.58
| Facility | | $311.56 | $425.28 | $490.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.80 / $558.94 / $558.94
| Facility | | $553.80 | $558.94 | $558.94 |
- 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 |