- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.72 / $354.68 / $3,740.00
| Facility | | $144.72 | $354.68 | $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
- $134.37 / $184.18 / $212.48
| Facility | | $134.37 | $184.18 | $212.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.74 / $242.07 / $242.07
| Facility | | $138.74 | $242.07 | $242.07 |
- 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 |