- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.74 / $3,776.00 / $9,062.00
| Facility | | $224.74 | $3,776.00 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,222.30 / $3,458.04 / $6,060.17
| Facility | | $1,222.30 | $3,458.04 | $6,060.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.94 / $375.00 / $1,370.63
| Facility | | $223.94 | $375.00 | $1,370.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.76 / $269.86 / $430.09
| Facility | | $217.76 | $269.86 | $430.09 |
- 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 |