- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.06 / $611.80 / $4,846.00
| Facility | | $238.06 | $611.80 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,600.00 / $11,226.46 / $15,429.17
| Facility | | $4,600.00 | $11,226.46 | $15,429.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.04 / $299.05 / $345.06
| Facility | | $230.04 | $299.05 | $345.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.02 / $298.02 / $761.00
| Facility | | $298.02 | $298.02 | $761.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.00 / $5,076.00 / $10,396.00
| Facility | | $612.00 | $5,076.00 | $10,396.00 |