- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.24 / $1,386.00 / $5,634.00
| Facility | | $166.24 | $1,386.00 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,840.00 / $7,036.00
| Facility | | $1,636.00 | $3,840.00 | $7,036.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.34 / $200.64 / $231.51
| Facility | | $154.34 | $200.64 | $231.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.68 / $402.00 / $848.27
| Facility | | $192.68 | $402.00 | $848.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,817.00 / $5,402.00
| Facility | | $900.00 | $3,817.00 | $5,402.00 |