- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.92 / $787.00 / $6,568.87
| Facility | | $285.92 | $787.00 | $6,568.87 |
- 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
- $311.45 / $424.55 / $489.74
| Facility | | $311.45 | $424.55 | $489.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.45 / $376.25 / $376.25
| Facility | | $300.45 | $376.25 | $376.25 |
- 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 |