- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.42 / $582.23 / $9,062.00
| Facility | | $121.42 | $582.23 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.84 / $1,393.51 / $3,447.14
| Facility | | $525.84 | $1,393.51 | $3,447.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $440.00 / $1,139.16
| Facility | | $375.00 | $440.00 | $1,139.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.42 / $310.00 / $456.27
| Facility | | $121.42 | $310.00 | $456.27 |
- 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 |