- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.17 / $860.00 / $3,740.00
| Facility | | $346.17 | $860.00 | $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
- $346.54 / $474.31 / $547.14
| Facility | | $346.54 | $474.31 | $547.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.01 / $415.26 / $415.26
| Facility | | $346.01 | $415.26 | $415.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |