- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $742.98 / $4,376.00 / $10,439.00
| Facility | | $742.98 | $4,376.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.00 / $808.00 / $1,697.41
| Facility | | $576.00 | $808.00 | $1,697.41 |
- 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
- $442.25 / $647.58 / $2,393.00
| Facility | | $442.25 | $647.58 | $2,393.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.00 / $3,096.00 / $5,562.00
| Facility | | $1,037.00 | $3,096.00 | $5,562.00 |