- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.98 / $2,090.55 / $9,062.00
| Facility | | $232.98 | $2,090.55 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.00 / $837.00 / $5,607.20
| Facility | | $448.00 | $837.00 | $5,607.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $615.00 / $1,842.86
| Facility | | $375.00 | $615.00 | $1,842.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.03 / $283.64 / $407.62
| Facility | | $198.03 | $283.64 | $407.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |