- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.92 / $306.67 / $7,278.00
| Facility | | $91.92 | $306.67 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.30 / $1,311.30 / $1,330.43
| Facility | | $1,311.30 | $1,311.30 | $1,330.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,215.60
| Facility | | $530.04 | $530.04 | $1,215.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.92 / $215.56 / $334.01
| Facility | | $91.92 | $215.56 | $334.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $542.04 / $542.04 / $16,394.00
| Facility | | $542.04 | $542.04 | $16,394.00 |