- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.11 / $394.52 / $5,320.00
| Facility | | $185.11 | $394.52 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,229.00
| Facility | | $1,258.00 | $2,316.00 | $4,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.16 / $235.59 / $271.77
| Facility | | $172.16 | $235.59 | $271.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.26 / $309.64 / $309.64
| Facility | | $206.26 | $309.64 | $309.64 |
- 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 |