- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.57 / $5,201.00 / $11,627.00
| Facility | | $289.57 | $5,201.00 | $11,627.00 |
- 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
- $149.50 / $183.29 / $1,021.85
| Facility | | $149.50 | $183.29 | $1,021.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.39 / $169.39 / $21,571.00
| Facility | | $169.39 | $169.39 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.00 / $881.00 / $2,833.00
| Facility | | $226.00 | $881.00 | $2,833.00 |