- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.97 / $1,615.00 / $5,115.45
| Facility | | $131.97 | $1,615.00 | $5,115.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.44 / $887.89 / $1,675.01
| Facility | | $323.44 | $887.89 | $1,675.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.76 / $980.01 / $1,361.51
| Facility | | $81.76 | $980.01 | $1,361.51 |
- 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
- $55.00 / $1,679.10 / $1,679.10
| Facility | | $55.00 | $1,679.10 | $1,679.10 |