- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.55 / $860.00 / $8,229.00
| Facility | | $146.55 | $860.00 | $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
- $143.38 / $196.78 / $227.01
| Facility | | $143.38 | $196.78 | $227.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.23 / $173.23 / $173.23
| Facility | | $173.23 | $173.23 | $173.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $794.00 / $5,301.00
| Facility | | $523.00 | $794.00 | $5,301.00 |