- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.43 / $787.00 / $3,740.00
| Facility | | $104.43 | $787.00 | $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
- $110.04 / $160.43 / $185.06
| Facility | | $110.04 | $160.43 | $185.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.44 / $140.44 / $140.44
| Facility | | $140.44 | $140.44 | $140.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $668.00 / $3,176.00
| Facility | | $50.00 | $668.00 | $3,176.00 |