- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.72 / $3,776.00 / $9,870.00
| Facility | | $138.72 | $3,776.00 | $9,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $589.00 / $3,055.65 / $6,163.57
| Facility | | $589.00 | $3,055.65 | $6,163.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.12 / $535.00 / $570.00
| Facility | | $134.12 | $535.00 | $570.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.92 / $148.22 / $235.84
| Facility | | $120.92 | $148.22 | $235.84 |
- 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 |