- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.24 / $1,086.08 / $9,062.00
| Facility | | $280.24 | $1,086.08 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.00 / $1,382.39 / $3,234.31
| Facility | | $603.00 | $1,382.39 | $3,234.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $570.00 / $834.39
| Facility | | $375.00 | $570.00 | $834.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.24 / $564.49 / $807.21
| Facility | | $280.24 | $564.49 | $807.21 |
- 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 |