- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.77 / $415.66 / $5,634.00
| Facility | | $192.77 | $415.66 | $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
- $177.58 / $230.85 / $476.62
| Facility | | $177.58 | $230.85 | $476.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.18 / $402.00 / $848.27
| Facility | | $337.18 | $402.00 | $848.27 |
- 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 |