- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.13 / $787.00 / $8,229.00
| Facility | | $149.13 | $787.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,292.00 / $4,066.00
| Facility | | $1,258.00 | $2,292.00 | $4,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.57 / $201.17 / $232.07
| Facility | | $146.57 | $201.17 | $232.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.03 / $176.03 / $176.03
| Facility | | $176.03 | $176.03 | $176.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $794.00 / $5,301.00
| Facility | | $523.00 | $794.00 | $5,301.00 |