- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.75 / $364.67 / $7,212.00
| Facility | | $163.75 | $364.67 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,058.00 / $7,572.00 / $18,942.00
| Facility | | $1,058.00 | $7,572.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.34 / $166.74 / $188.63
| Facility | | $160.34 | $166.74 | $188.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.38 / $761.00 / $1,158.10
| Facility | | $282.38 | $761.00 | $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 |