- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.37 / $5,467.00 / $12,237.00
| Facility | | $574.37 | $5,467.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.10 / $2,151.96 / $3,412.16
| Facility | | $1,461.10 | $2,151.96 | $3,412.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $624.00 / $624.00
| Facility | | $624.00 | $624.00 | $624.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.18 / $572.71 / $3,561.00
| Facility | | $310.18 | $572.71 | $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 |