- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.25 / $787.00 / $9,311.00
| Facility | | $289.25 | $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
- $287.88 / $394.69 / $455.30
| Facility | | $287.88 | $394.69 | $455.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.10 / $346.78 / $346.78
| Facility | | $326.10 | $346.78 | $346.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,450.00 / $5,301.00
| Facility | | $523.00 | $1,450.00 | $5,301.00 |