- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.89 / $842.80 / $9,062.00
| Facility | | $101.89 | $842.80 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.87 / $2,186.31 / $3,821.14
| Facility | | $852.87 | $2,186.31 | $3,821.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $901.20 / $1,158.06
| Facility | | $375.00 | $901.20 | $1,158.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.89 / $187.33 / $296.35
| Facility | | $101.89 | $187.33 | $296.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |