- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.45 / $5,866.00 / $16,467.00
| Facility | | $198.45 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.00 / $830.24 / $924.04
| Facility | | $695.00 | $830.24 | $924.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.87 / $505.00 / $890.00
| Facility | | $200.87 | $505.00 | $890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.54 / $248.06 / $406.60
| Facility | | $194.54 | $248.06 | $406.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $1,221.00 / $3,585.00
| Facility | | $225.00 | $1,221.00 | $3,585.00 |