- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.41 / $2,113.00 / $10,268.00
| Facility | | $222.41 | $2,113.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,051.00 / $1,981.00 / $3,943.00
| Facility | | $1,051.00 | $1,981.00 | $3,943.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.66 / $139.30 / $165.52
| Facility | | $113.66 | $139.30 | $165.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.46 / $201.46 / $21,571.00
| Facility | | $201.46 | $201.46 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.46 / $201.46 / $290.62
| Facility | | $201.46 | $201.46 | $290.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $1,940.00 / $4,132.00
| Facility | | $1,020.00 | $1,940.00 | $4,132.00 |