- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.20 / $685.77 / $16,467.00
| Facility | | $289.20 | $685.77 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,373.28 / $5,135.30 / $9,383.48
| Facility | | $2,373.28 | $5,135.30 | $9,383.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.16 / $435.16 / $890.00
| Facility | | $435.16 | $435.16 | $890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.60 / $507.25 / $961.88
| Facility | | $286.60 | $507.25 | $961.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,607.00 / $8,667.00
| Facility | | $729.00 | $6,607.00 | $8,667.00 |