- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.87 / $787.00 / $9,311.00
| Facility | | $285.87 | $787.00 | $9,311.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.00 / $3,967.00 / $8,800.00
| Facility | | $2,088.00 | $3,967.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.64 / $377.78 / $435.78
| Facility | | $309.64 | $377.78 | $435.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.89
| Facility | | $331.13 | $331.13 | $331.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |