- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.67 / $2,303.00 / $6,305.47
| Facility | | $361.67 | $2,303.00 | $6,305.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,565.00 / $3,395.00 / $5,774.00
| Facility | | $1,565.00 | $3,395.00 | $5,774.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.98 / $500.00 / $2,277.00
| Facility | | $334.98 | $500.00 | $2,277.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,730.22 / $2,116.15
| Facility | | $55.00 | $1,730.22 | $2,116.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,260.00 / $4,099.00
| Facility | | $875.00 | $2,260.00 | $4,099.00 |