- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.33 / $787.00 / $8,229.00
| Facility | | $245.33 | $787.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,830.00 / $8,584.00 / $11,253.00
| Facility | | $5,830.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.16 / $324.14 / $373.92
| Facility | | $236.16 | $324.14 | $373.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.48 / $278.48 / $278.48
| Facility | | $278.48 | $278.48 | $278.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |