- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.72 / $390.79 / $903.00
| Facility | | $150.72 | $390.79 | $903.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,799.51 / $2,794.81 / $4,391.24
| Facility | | $1,799.51 | $2,794.81 | $4,391.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.53 / $154.53 / $1,128.18
| Facility | | $153.53 | $154.53 | $1,128.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.72 / $338.71 / $1,145.00
| Facility | | $150.72 | $338.71 | $1,145.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $610.00 / $1,883.00
| Facility | | $100.00 | $610.00 | $1,883.00 |