- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.67 / $787.00 / $8,229.00
| Facility | | $318.67 | $787.00 | $8,229.00 |
- 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
- $382.95 / $517.40 / $596.85
| Facility | | $382.95 | $517.40 | $596.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.03 / $455.03 / $535.50
| Facility | | $455.03 | $455.03 | $535.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |