- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.17 / $329.93 / $10,647.00
| Facility | | $206.17 | $329.93 | $10,647.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,222.60 / $4,815.76 / $11,253.00
| Facility | | $2,222.60 | $4,815.76 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.95 / $268.95 / $310.25
| Facility | | $195.95 | $268.95 | $310.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.28 / $237.28 / $237.28
| Facility | | $237.28 | $237.28 | $237.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |