- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.63 / $492.69 / $3,740.00
| Facility | | $297.63 | $492.69 | $3,740.00 |
- 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
- $267.22 / $387.24 / $456.96
| Facility | | $267.22 | $387.24 | $456.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.27 / $341.27 / $525.64
| Facility | | $341.27 | $341.27 | $525.64 |
- 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 |