- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $957.00 / $3,498.00 / $10,439.00
| Facility | | $957.00 | $3,498.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $653.00 / $911.76 / $1,543.97
| Facility | | $653.00 | $911.76 | $1,543.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.00 / $1,384.00 / $2,437.00
| Facility | | $596.00 | $1,384.00 | $2,437.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.57 / $292.73 / $2,127.41
| Facility | | $137.57 | $292.73 | $2,127.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.00 / $3,096.00 / $5,562.00
| Facility | | $1,037.00 | $3,096.00 | $5,562.00 |