- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.37 / $543.00 / $4,846.00
| Facility | | $150.37 | $543.00 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,635.00 / $5,445.00
| Facility | | $1,636.00 | $3,635.00 | $5,445.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.55 / $186.62 / $357.16
| Facility | | $143.55 | $186.62 | $357.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.83 / $260.83 / $402.00
| Facility | | $260.83 | $260.83 | $402.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $2,174.00 / $4,426.00
| Facility | | $500.00 | $2,174.00 | $4,426.00 |