- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.70 / $3,600.00 / $10,439.00
| Facility | | $443.70 | $3,600.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.94 / $1,752.80 / $3,084.55
| Facility | | $60.94 | $1,752.80 | $3,084.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.00 / $442.00 / $442.00
| Facility | | $442.00 | $442.00 | $442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.35 / $456.11 / $6,026.00
| Facility | | $274.35 | $456.11 | $6,026.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $3,096.00 / $5,565.00
| Facility | | $1,436.00 | $3,096.00 | $5,565.00 |