- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.67 / $9,243.32 / $16,467.00
| Facility | | $306.67 | $9,243.32 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,871.55 / $3,870.04 / $6,700.72
| Facility | | $1,871.55 | $3,870.04 | $6,700.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.10 / $715.00 / $890.00
| Facility | | $304.10 | $715.00 | $890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.49 / $387.00 / $601.66
| Facility | | $300.49 | $387.00 | $601.66 |
- 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 |