- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.96 / $504.70 / $5,634.00
| Facility | | $340.96 | $504.70 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,914.00 / $15,727.00
| Facility | | $1,682.00 | $3,914.00 | $15,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.89 / $410.67 / $575.14
| Facility | | $315.89 | $410.67 | $575.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.00 / $578.22 / $3,909.74
| Facility | | $402.00 | $578.22 | $3,909.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,995.00 / $9,243.00
| Facility | | $1,500.00 | $5,995.00 | $9,243.00 |