- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.22 / $1,386.00 / $17,945.00
| Facility | | $145.22 | $1,386.00 | $17,945.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.96 / $4,119.97 / $8,230.00
| Facility | | $740.96 | $4,119.97 | $8,230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.06 / $182.08 / $326.12
| Facility | | $140.06 | $182.08 | $326.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.05 / $506.05 / $599.87
| Facility | | $506.05 | $506.05 | $599.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $3,267.00 / $4,271.00
| Facility | | $1,638.00 | $3,267.00 | $4,271.00 |