- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.58 / $5,866.00 / $16,467.00
| Facility | | $273.58 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.64 / $1,406.37 / $2,488.86
| Facility | | $714.64 | $1,406.37 | $2,488.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.72 / $505.00 / $890.00
| Facility | | $273.72 | $505.00 | $890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.04 / $314.62 / $540.17
| Facility | | $227.04 | $314.62 | $540.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,607.00 / $8,667.00
| Facility | | $729.00 | $6,607.00 | $8,667.00 |