- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.18 / $183.18 / $2,168.00
| Facility | | $183.18 | $183.18 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,996.04 / $5,151.84 / $10,380.54
| Facility | | $1,996.04 | $5,151.84 | $10,380.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.57 / $668.88 / $1,609.09
| Facility | | $428.57 | $668.88 | $1,609.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.39 / $610.40 / $1,267.00
| Facility | | $371.39 | $610.40 | $1,267.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.03 / $381.34 / $2,296.00
| Facility | | $192.03 | $381.34 | $2,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $3,500.00 / $6,361.00
| Facility | | $1,224.00 | $3,500.00 | $6,361.00 |