- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.08 / $731.00 / $7,212.00
| Facility | | $152.08 | $731.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,749.00 / $4,353.00 / $8,052.00
| Facility | | $1,749.00 | $4,353.00 | $8,052.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.56 / $191.83 / $421.12
| Facility | | $147.56 | $191.83 | $421.12 |
- 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 |