- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.17 / $405.88 / $5,634.00
| Facility | | $83.17 | $405.88 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,840.00 / $7,747.00
| Facility | | $1,682.00 | $3,840.00 | $7,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.20 / $98.41 / $208.01
| Facility | | $77.20 | $98.41 | $208.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $949.22 / $949.22 / $949.22
| Facility | | $949.22 | $949.22 | $949.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $3,870.00 / $5,490.00
| Facility | | $2,400.00 | $3,870.00 | $5,490.00 |