- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.27 / $209.92 / $5,634.00
| Facility | | $81.27 | $209.92 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.96 / $3,896.00 / $8,230.00
| Facility | | $740.96 | $3,896.00 | $8,230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.28 / $101.76 / $170.96
| Facility | | $78.28 | $101.76 | $170.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.52 / $640.52 / $759.27
| Facility | | $640.52 | $640.52 | $759.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $3,267.00 / $4,271.00
| Facility | | $1,638.00 | $3,267.00 | $4,271.00 |