- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.36 / $247.36 / $6,781.00
| Facility | | $247.36 | $247.36 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,597.22 / $6,373.77 / $12,643.17
| Facility | | $3,597.22 | $6,373.77 | $12,643.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.34 / $936.44 / $2,252.73
| Facility | | $660.34 | $936.44 | $2,252.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.79 / $856.13 / $1,773.80
| Facility | | $536.79 | $856.13 | $1,773.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $349.31 / $526.05 / $7,666.32
| Facility | | $349.31 | $526.05 | $7,666.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |