- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.01 / $4,375.00 / $16,467.00
| Facility | | $319.01 | $4,375.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,085.44 / $4,408.50 / $7,418.57
| Facility | | $2,085.44 | $4,408.50 | $7,418.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.89 / $375.00 / $1,512.28
| Facility | | $306.89 | $375.00 | $1,512.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.16 / $380.49 / $594.79
| Facility | | $297.16 | $380.49 | $594.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |