- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.92 / $3,776.00 / $9,870.00
| Facility | | $183.92 | $3,776.00 | $9,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.00 / $837.00 / $4,285.27
| Facility | | $448.00 | $837.00 | $4,285.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $615.00 / $1,139.16
| Facility | | $375.00 | $615.00 | $1,139.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.33 / $174.64 / $312.66
| Facility | | $156.33 | $174.64 | $312.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |