- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.51 / $582.73 / $5,634.00
| Facility | | $136.51 | $582.73 | $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
- $126.50 / $164.45 / $479.97
| Facility | | $126.50 | $164.45 | $479.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.96 / $402.00 / $1,158.10
| Facility | | $238.96 | $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 |