- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.00 / $3,402.00 / $10,439.00
| Facility | | $487.00 | $3,402.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.00 / $853.43 / $1,968.49
| Facility | | $384.00 | $853.43 | $1,968.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $624.00 / $624.00
| Facility | | $624.00 | $624.00 | $624.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.21 / $294.93 / $1,541.00
| Facility | | $140.21 | $294.93 | $1,541.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.00 / $1,341.00 / $2,793.00
| Facility | | $525.00 | $1,341.00 | $2,793.00 |