- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276.68 / $3,637.00 / $10,439.00
| Facility | | $276.68 | $3,637.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.20 / $1,461.32 / $2,429.98
| Facility | | $1,041.20 | $1,461.32 | $2,429.98 |
- 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
- $122.57 / $308.25 / $1,915.00
| Facility | | $122.57 | $308.25 | $1,915.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.00 / $550.00 / $1,769.00
| Facility | | $191.00 | $550.00 | $1,769.00 |