- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.88 / $806.15 / $9,062.00
| Facility | | $189.88 | $806.15 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.04 / $2,763.33 / $5,322.64
| Facility | | $924.04 | $2,763.33 | $5,322.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.27 / $505.00 / $781.44
| Facility | | $273.27 | $505.00 | $781.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.88 / $371.04 / $608.78
| Facility | | $189.88 | $371.04 | $608.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $3,866.00 / $6,584.00
| Facility | | $490.00 | $3,866.00 | $6,584.00 |