- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.26 / $1,419.57 / $9,062.00
| Facility | | $279.26 | $1,419.57 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.00 / $1,832.44 / $3,784.63
| Facility | | $567.00 | $1,832.44 | $3,784.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $440.00 / $933.68
| Facility | | $375.00 | $440.00 | $933.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.72 / $596.47 / $930.35
| Facility | | $274.72 | $596.47 | $930.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |