- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.32 / $4,230.00 / $9,727.00
| Facility | | $578.32 | $4,230.00 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.64 / $438.34 / $786.00
| Facility | | $208.64 | $438.34 | $786.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $780.00 / $1,370.63
| Facility | | $505.00 | $780.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.46 / $701.14 / $1,140.20
| Facility | | $518.46 | $701.14 | $1,140.20 |
- 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 |