- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.31 / $806.60 / $9,062.00
| Facility | | $197.31 | $806.60 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.69 / $1,526.52 / $3,447.14
| Facility | | $618.69 | $1,526.52 | $3,447.14 |
- 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
- $193.83 / $400.96 / $595.27
| Facility | | $193.83 | $400.96 | $595.27 |
- 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 |