- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.54 / $787.00 / $3,740.00
| Facility | | $243.54 | $787.00 | $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
- $282.30 / $404.36 / $477.17
| Facility | | $282.30 | $404.36 | $477.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.91 / $354.91 / $416.88
| Facility | | $354.91 | $354.91 | $416.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,168.00 / $6,186.00 / $20,161.00
| Facility | | $1,168.00 | $6,186.00 | $20,161.00 |