- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.58 / $526.92 / $5,320.00
| Facility | | $295.58 | $526.92 | $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
- $277.62 / $381.05 / $439.57
| Facility | | $277.62 | $381.05 | $439.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.68 / $500.81 / $500.81
| Facility | | $354.68 | $500.81 | $500.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $3,086.00 / $6,359.06
| Facility | | $599.00 | $3,086.00 | $6,359.06 |