- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.26 / $4,777.00 / $12,154.00
| Facility | | $323.26 | $4,777.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,686.33 / $1,686.33 / $1,686.33
| Facility | | $1,686.33 | $1,686.33 | $1,686.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.00 / $1,516.00 / $1,781.00
| Facility | | $914.00 | $1,516.00 | $1,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.62 / $277.06 / $3,561.00
| Facility | | $121.62 | $277.06 | $3,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $2,185.71 / $5,562.00
| Facility | | $1,436.00 | $2,185.71 | $5,562.00 |