- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.38 / $1,394.36 / $6,519.00
| Facility | | $373.38 | $1,394.36 | $6,519.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.24 / $685.00 / $1,226.89
| Facility | | $453.24 | $685.00 | $1,226.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.56 / $524.47 / $774.45
| Facility | | $235.56 | $524.47 | $774.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,338.20 / $1,338.20 / $16,394.00
| Facility | | $1,338.20 | $1,338.20 | $16,394.00 |