- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.10 / $373.67 / $5,634.00
| Facility | | $100.10 | $373.67 | $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
- $94.34 / $120.24 / $435.96
| Facility | | $94.34 | $120.24 | $435.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.79 / $402.00 / $1,158.10
| Facility | | $172.79 | $402.00 | $1,158.10 |
- 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 |