- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.08 / $4,387.00 / $10,439.00
| Facility | | $373.08 | $4,387.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.00 / $768.56 / $1,279.35
| Facility | | $578.00 | $768.56 | $1,279.35 |
- 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
- $134.74 / $352.12 / $1,915.00
| Facility | | $134.74 | $352.12 | $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 |