- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.45 / $1,245.00 / $7,278.00
| Facility | | $315.45 | $1,245.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $25,215.68
| Facility | | $530.04 | $530.04 | $25,215.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.00 / $364.25 / $562.30
| Facility | | $238.00 | $364.25 | $562.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.76 / $72,736.14 / $83,333.30
| Facility | | $1,763.76 | $72,736.14 | $83,333.30 |