- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.22 / $787.00 / $9,471.12
| Facility | | $293.22 | $787.00 | $9,471.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,320.00 / $4,041.00 / $11,433.00
| Facility | | $2,320.00 | $4,041.00 | $11,433.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.58 / $397.46 / $458.51
| Facility | | $289.58 | $397.46 | $458.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.77 / $522.38 / $522.38
| Facility | | $304.77 | $522.38 | $522.38 |
- 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 |