- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.43 / $470.16 / $3,740.00
| Facility | | $297.43 | $470.16 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.80 / $378.55 / $436.68
| Facility | | $275.80 | $378.55 | $436.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.89 / $497.52 / $497.52
| Facility | | $291.89 | $497.52 | $497.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,450.00 / $5,301.00
| Facility | | $523.00 | $1,450.00 | $5,301.00 |