- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.61 / $1,386.00 / $7,212.00
| Facility | | $146.61 | $1,386.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,042.00 / $5,230.00 / $8,240.00
| Facility | | $1,042.00 | $5,230.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.31 / $190.52 / $341.55
| Facility | | $142.31 | $190.52 | $341.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.48 / $546.36 / $1,375.01
| Facility | | $259.48 | $546.36 | $1,375.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,076.00 / $5,995.00 / $10,413.00
| Facility | | $1,076.00 | $5,995.00 | $10,413.00 |