- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.52 / $442.31 / $3,740.00
| Facility | | $60.52 | $442.31 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,584.00 / $10,099.00 / $11,253.00
| Facility | | $8,584.00 | $10,099.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.45 / $81.59 / $94.13
| Facility | | $59.45 | $81.59 | $94.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.24 / $107.24 / $107.24
| Facility | | $107.24 | $107.24 | $107.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $3,176.00
| Facility | | $50.00 | $597.00 | $3,176.00 |