- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.37 / $433.22 / $5,634.00
| Facility | | $253.37 | $433.22 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,840.00 / $7,036.00
| Facility | | $1,636.00 | $3,840.00 | $7,036.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.03 / $312.30 / $485.55
| Facility | | $245.03 | $312.30 | $485.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.00 / $443.40 / $1,868.80
| Facility | | $402.00 | $443.40 | $1,868.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,817.00 / $5,402.00
| Facility | | $900.00 | $3,817.00 | $5,402.00 |