- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.54 / $186.43 / $4,846.00
| Facility | | $72.54 | $186.43 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.96 / $4,119.97 / $8,230.00
| Facility | | $740.96 | $4,119.97 | $8,230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.65 / $96.96 / $145.44
| Facility | | $70.65 | $96.96 | $145.44 |
- 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 |