- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.07 / $4,947.00 / $11,581.00
| Facility | | $622.07 | $4,947.00 | $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
- $350.92 / $400.94 / $1,532.78
| Facility | | $350.92 | $400.94 | $1,532.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.39 / $326.39 / $21,571.00
| Facility | | $326.39 | $326.39 | $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 |