- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.26 / $4,751.00 / $18,857.00
| Facility | | $136.26 | $4,751.00 | $18,857.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,821.65 / $19,232.43 / $34,283.46
| Facility | | $7,821.65 | $19,232.43 | $34,283.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.09 / $134.09 / $890.00
| Facility | | $134.09 | $134.09 | $890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.85 / $190.70 / $276.05
| Facility | | $131.85 | $190.70 | $276.05 |
- 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 |