- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.34 / $616.09 / $5,320.00
| Facility | | $357.34 | $616.09 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,215.00 / $2,292.00 / $4,229.00
| Facility | | $1,215.00 | $2,292.00 | $4,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.38 / $462.31 / $528.35
| Facility | | $329.38 | $462.31 | $528.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.06 / $408.61 / $1,117.44
| Facility | | $310.06 | $408.61 | $1,117.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |