- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.72 / $4,230.00 / $9,062.00
| Facility | | $188.72 | $4,230.00 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.00 / $1,940.27 / $3,606.23
| Facility | | $567.00 | $1,940.27 | $3,606.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $615.00 / $834.39
| Facility | | $375.00 | $615.00 | $834.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.55 / $446.49 / $4,372.13
| Facility | | $180.55 | $446.49 | $4,372.13 |
- 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 |