- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.79 / $447.96 / $5,320.00
| Facility | | $204.79 | $447.96 | $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
- $190.03 / $260.64 / $300.66
| Facility | | $190.03 | $260.64 | $300.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.55 / $342.55 / $377.18
| Facility | | $342.55 | $342.55 | $377.18 |
- 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 |