- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.49 / $530.44 / $5,320.00
| Facility | | $168.49 | $530.44 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,421.00 / $2,745.00 / $10,277.00
| Facility | | $1,421.00 | $2,745.00 | $10,277.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.38 / $214.44 / $247.36
| Facility | | $156.38 | $214.44 | $247.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.33 / $281.83 / $281.83
| Facility | | $157.33 | $281.83 | $281.83 |
- 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 |