- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.65 / $988.00 / $8,229.00
| Facility | | $117.65 | $988.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.38 / $158.37 / $182.69
| Facility | | $115.38 | $158.37 | $182.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.34 / $139.34 / $139.34
| Facility | | $139.34 | $139.34 | $139.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $794.00 / $5,301.00
| Facility | | $523.00 | $794.00 | $5,301.00 |