- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.68 / $463.74 / $8,229.00
| Facility | | $190.68 | $463.74 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,066.00 / $2,315.00 / $4,322.00
| Facility | | $1,066.00 | $2,315.00 | $4,322.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.91 / $256.55 / $295.94
| Facility | | $186.91 | $256.55 | $295.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.18 / $337.18 / $337.18
| Facility | | $337.18 | $337.18 | $337.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,339.00 / $5,301.00
| Facility | | $523.00 | $1,339.00 | $5,301.00 |