- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.14 / $407.24 / $5,634.00
| Facility | | $126.14 | $407.24 | $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
- $116.89 / $151.96 / $471.51
| Facility | | $116.89 | $151.96 | $471.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.30 / $402.00 / $1,158.10
| Facility | | $221.30 | $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 |