- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.17 / $416.00 / $8,229.00
| Facility | | $244.17 | $416.00 | $8,229.00 |
- 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
- $245.80 / $337.37 / $389.18
| Facility | | $245.80 | $337.37 | $389.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.40 / $443.40 / $443.40
| Facility | | $443.40 | $443.40 | $443.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $794.00 / $5,301.00
| Facility | | $523.00 | $794.00 | $5,301.00 |