- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.36 / $860.00 / $8,229.00
| Facility | | $290.36 | $860.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,942.00 / $4,423.00 / $10,099.00
| Facility | | $2,942.00 | $4,423.00 | $10,099.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.33 / $387.52 / $447.03
| Facility | | $282.33 | $387.52 | $447.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.86 / $341.86 / $341.86
| Facility | | $341.86 | $341.86 | $341.86 |
- 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 |