- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.45 / $437.37 / $3,740.00
| Facility | | $262.45 | $437.37 | $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
- $243.37 / $334.04 / $385.34
| Facility | | $243.37 | $334.04 | $385.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.67 / $439.02 / $439.02
| Facility | | $283.67 | $439.02 | $439.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $3,176.00
| Facility | | $50.00 | $597.00 | $3,176.00 |