- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.66 / $1,933.57 / $9,062.00
| Facility | | $132.66 | $1,933.57 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.77 / $900.66 / $2,150.09
| Facility | | $517.77 | $900.66 | $2,150.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $569.33 / $663.59
| Facility | | $375.00 | $569.33 | $663.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.39 / $856.01 / $1,312.06
| Facility | | $56.39 | $856.01 | $1,312.06 |
- 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 |