- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.26 / $527.15 / $8,229.00
| Facility | | $215.26 | $527.15 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,066.00 / $2,163.00 / $4,322.00
| Facility | | $1,066.00 | $2,163.00 | $4,322.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.00 / $288.23 / $332.50
| Facility | | $210.00 | $288.23 | $332.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.82 / $378.82 / $378.82
| Facility | | $378.82 | $378.82 | $378.82 |
- 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 |