- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.71 / $928.46 / $7,278.00
| Facility | | $160.71 | $928.46 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.24 / $842.52 / $1,675.01
| Facility | | $453.24 | $842.52 | $1,675.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.71 / $279.58 / $761.12
| Facility | | $160.71 | $279.58 | $761.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,113.54 / $1,113.54 / $16,394.00
| Facility | | $1,113.54 | $1,113.54 | $16,394.00 |