- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.66 / $325.95 / $5,320.00
| Facility | | $128.66 | $325.95 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,066.00
| Facility | | $1,258.00 | $2,316.00 | $4,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.47 / $207.93 / $245.38
| Facility | | $146.47 | $207.93 | $245.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.73 / $273.27 / $273.27
| Facility | | $193.73 | $273.27 | $273.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.00 / $950.00 / $3,394.00
| Facility | | $391.00 | $950.00 | $3,394.00 |