- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.83 / $2,288.39 / $6,214.00
| Facility | | $256.83 | $2,288.39 | $6,214.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.50 / $1,458.00 / $2,244.00
| Facility | | $602.50 | $1,458.00 | $2,244.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.45 / $529.00 / $2,213.00
| Facility | | $259.45 | $529.00 | $2,213.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,059.90 / $1,081.85 / $16,394.00
| Facility | | $1,059.90 | $1,081.85 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.00 / $740.00 / $2,127.00
| Facility | | $231.00 | $740.00 | $2,127.00 |