- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.73 / $4,886.00 / $11,581.00
| Facility | | $575.73 | $4,886.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.00 / $2,170.00 / $6,565.00
| Facility | | $937.00 | $2,170.00 | $6,565.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.15 / $300.56 / $1,021.85
| Facility | | $245.15 | $300.56 | $1,021.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.42 / $227.42 / $21,571.00
| Facility | | $227.42 | $227.42 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.91 / $0.91 / $0.91
| Facility | | $0.91 | $0.91 | $0.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.00 / $881.00 / $2,833.00
| Facility | | $226.00 | $881.00 | $2,833.00 |