- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.52 / $787.00 / $5,320.00
| Facility | | $228.52 | $787.00 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,389.00
| Facility | | $1,258.00 | $2,316.00 | $4,389.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.74 / $405.06 / $478.00
| Facility | | $279.74 | $405.06 | $478.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.42 / $355.25 / $355.25
| Facility | | $282.42 | $355.25 | $355.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $25,249.00
| Facility | | $842.00 | $4,539.00 | $25,249.00 |