- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.03 / $514.25 / $5,449.00
| Facility | | $179.03 | $514.25 | $5,449.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $1,438.74
| Facility | | $395.75 | $395.75 | $1,438.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.61 / $388.64 / $871.00
| Facility | | $182.61 | $388.64 | $871.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $481.12 / $931.19 / $12,000.00
| Facility | | $481.12 | $931.19 | $12,000.00 |