- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.12 / $219.12 / $2,525.00
| Facility | | $219.12 | $219.12 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,035.05 / $10,766.58 / $24,323.22
| Facility | | $1,035.05 | $10,766.58 | $24,323.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.41 / $723.83 / $1,741.27
| Facility | | $510.41 | $723.83 | $1,741.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.93 / $661.75 / $1,371.08
| Facility | | $414.93 | $661.75 | $1,371.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.44 / $424.54 / $9,233.00
| Facility | | $305.44 | $424.54 | $9,233.00 |
- 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 |