- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.84 / $294.89 / $5,634.00
| Facility | | $101.84 | $294.89 | $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
- $94.54 / $122.90 / $340.52
| Facility | | $94.54 | $122.90 | $340.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.75 / $402.00 / $848.27
| Facility | | $176.75 | $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 |