- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.43 / $453.94 / $3,740.00
| Facility | | $397.43 | $453.94 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,010.00 / $2,045.00 / $2,978.00
| Facility | | $1,010.00 | $2,045.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.36 / $526.83 / $602.10
| Facility | | $377.36 | $526.83 | $602.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.84 / $477.96 / $1,322.53
| Facility | | $344.84 | $477.96 | $1,322.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,450.00 / $5,301.00
| Facility | | $523.00 | $1,450.00 | $5,301.00 |