- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.51 / $297.20 / $5,634.00
| Facility | | $55.51 | $297.20 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,635.00 / $5,445.00
| Facility | | $1,636.00 | $3,635.00 | $5,445.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.09 / $67.72 / $241.74
| Facility | | $52.09 | $67.72 | $241.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.93 / $402.00 / $674.63
| Facility | | $96.93 | $402.00 | $674.63 |
- 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 |