- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.18 / $816.83 / $5,634.00
| Facility | | $84.18 | $816.83 | $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
- $78.26 / $101.74 / $968.34
| Facility | | $78.26 | $101.74 | $968.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.88 / $402.00 / $1,158.10
| Facility | | $145.88 | $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 |