- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.70 / $1,386.00 / $7,212.00
| Facility | | $186.70 | $1,386.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,943.00 / $5,117.00 / $8,240.00
| Facility | | $1,943.00 | $5,117.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.13 / $223.21 / $257.55
| Facility | | $175.13 | $223.21 | $257.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.16 / $538.00 / $1,158.10
| Facility | | $215.16 | $538.00 | $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 |