- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.48 / $3,131.00 / $10,439.00
| Facility | | $372.48 | $3,131.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.50 / $864.51 / $1,438.28
| Facility | | $617.50 | $864.51 | $1,438.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.00 / $596.00 / $621.00
| Facility | | $556.00 | $596.00 | $621.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.84 / $159.61 / $1,483.00
| Facility | | $76.84 | $159.61 | $1,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.00 / $2,081.00 / $3,918.00
| Facility | | $816.00 | $2,081.00 | $3,918.00 |