- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.82 / $989.30 / $9,062.00
| Facility | | $267.82 | $989.30 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,476.67 / $5,309.27 / $8,927.19
| Facility | | $2,476.67 | $5,309.27 | $8,927.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $505.00 / $1,965.14
| Facility | | $505.00 | $505.00 | $1,965.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $233.50 / $352.40 / $515.74
| Facility | | $233.50 | $352.40 | $515.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |