- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $718.51 / $4,376.00 / $12,154.00
| Facility | | $718.51 | $4,376.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.00 / $1,332.33 / $1,402.45
| Facility | | $547.00 | $1,332.33 | $1,402.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $505.00 / $505.00
| Facility | | $505.00 | $505.00 | $505.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.73 / $731.20 / $3,561.00
| Facility | | $431.73 | $731.20 | $3,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $3,096.00 / $5,562.00
| Facility | | $1,436.00 | $3,096.00 | $5,562.00 |