- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.94 / $4,846.00 / $9,115.01
| Facility | | $112.94 | $4,846.00 | $9,115.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,140.00 / $5,958.00 / $9,462.00
| Facility | | $2,140.00 | $5,958.00 | $9,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.02 / $136.53 / $157.53
| Facility | | $105.02 | $136.53 | $157.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.31 / $615.00 / $1,873.52
| Facility | | $131.31 | $615.00 | $1,873.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,850.00 / $5,174.00 / $9,243.00
| Facility | | $1,850.00 | $5,174.00 | $9,243.00 |