- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.71 / $486.26 / $5,634.00
| Facility | | $380.71 | $486.26 | $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
- $350.64 / $455.83 / $553.99
| Facility | | $350.64 | $455.83 | $553.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.00 / $656.22 / $1,868.80
| Facility | | $402.00 | $656.22 | $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 |