- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.02 / $228.02 / $2,525.00
| Facility | | $228.02 | $228.02 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,072.54 / $10,766.58 / $24,323.22
| Facility | | $1,072.54 | $10,766.58 | $24,323.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.47 / $753.69 / $1,813.10
| Facility | | $531.47 | $753.69 | $1,813.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.05 / $689.05 / $1,427.64
| Facility | | $432.05 | $689.05 | $1,427.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.05 / $442.17 / $9,255.00
| Facility | | $312.05 | $442.17 | $9,255.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |