- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.97 / $375.75 / $8,229.00
| Facility | | $113.97 | $375.75 | $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
- $107.62 / $148.91 / $175.18
| Facility | | $107.62 | $148.91 | $175.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.46 / $201.46 / $201.46
| Facility | | $201.46 | $201.46 | $201.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.00 / $1,335.00 / $3,968.00
| Facility | | $391.00 | $1,335.00 | $3,968.00 |