- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.12 / $787.00 / $8,229.00
| Facility | | $510.12 | $787.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,389.00
| Facility | | $1,258.00 | $2,316.00 | $4,389.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.01 / $700.01 / $807.52
| Facility | | $510.01 | $700.01 | $807.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.33 / $612.60 / $612.60
| Facility | | $527.33 | $612.60 | $612.60 |
- 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 |