- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.33 / $429.10 / $9,727.00
| Facility | | $172.33 | $429.10 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.34 / $4,554.70 / $7,996.46
| Facility | | $1,794.34 | $4,554.70 | $7,996.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $1,221.33 / $1,569.43
| Facility | | $375.00 | $1,221.33 | $1,569.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.55 / $228.96 / $350.00
| Facility | | $148.55 | $228.96 | $350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |