- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.20 / $939.68 / $16,467.00
| Facility | | $263.20 | $939.68 | $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 / $1,604.11
| Facility | | $580.00 | $580.00 | $1,604.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.50 / $339.22 / $464.14
| Facility | | $229.50 | $339.22 | $464.14 |
- 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 |