- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.64 / $1,243.00 / $26,644.68
| Facility | | $437.64 | $1,243.00 | $26,644.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,755.00 / $8,584.00 / $11,253.00
| Facility | | $4,755.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $423.80 / $577.35 / $666.01
| Facility | | $423.80 | $577.35 | $666.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.17 / $507.17 / $648.12
| Facility | | $507.17 | $507.17 | $648.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,600.00 / $14,324.00 / $33,259.00
| Facility | | $1,600.00 | $14,324.00 | $33,259.00 |