- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.93 / $381.65 / $4,846.00
| Facility | | $155.93 | $381.65 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,058.00 / $7,572.00 / $18,942.00
| Facility | | $1,058.00 | $7,572.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.22 / $184.90 / $213.35
| Facility | | $142.22 | $184.90 | $213.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.77 / $185.77 / $761.00
| Facility | | $185.77 | $185.77 | $761.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $2,174.00 / $4,426.00
| Facility | | $500.00 | $2,174.00 | $4,426.00 |