- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.16 / $538.64 / $9,727.00
| Facility | | $134.16 | $538.64 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,984.85 / $4,324.38 / $8,116.91
| Facility | | $1,984.85 | $4,324.38 | $8,116.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.56 / $265.56 / $375.00
| Facility | | $265.56 | $265.56 | $375.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.71 / $238.07 / $378.90
| Facility | | $125.71 | $238.07 | $378.90 |
- 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 |