- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.02 / $547.29 / $16,467.00
| Facility | | $144.02 | $547.29 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,709.21 / $5,405.49 / $8,981.33
| Facility | | $2,709.21 | $5,405.49 | $8,981.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $580.00 / $580.00
| Facility | | $580.00 | $580.00 | $580.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.61 / $231.32 / $338.08
| Facility | | $131.61 | $231.32 | $338.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $1,221.00 / $3,585.00
| Facility | | $225.00 | $1,221.00 | $3,585.00 |