- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.97 / $1,837.00 / $9,062.00
| Facility | | $270.97 | $1,837.00 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.00 / $1,360.13 / $3,234.31
| Facility | | $520.00 | $1,360.13 | $3,234.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $440.00 / $834.39
| Facility | | $375.00 | $440.00 | $834.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.97 / $612.91 / $1,121.84
| Facility | | $270.97 | $612.91 | $1,121.84 |
- 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 |