- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.67 / $416.00 / $3,740.00
| Facility | | $32.67 | $416.00 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,206.97 / $9,407.91 / $15,719.31
| Facility | | $5,206.97 | $9,407.91 | $15,719.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31.90 / $43.53 / $50.22
| Facility | | $31.90 | $43.53 | $50.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.03 / $38.03 / $49.98
| Facility | | $38.03 | $38.03 | $49.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,572.00 / $10,917.00 / $31,320.00
| Facility | | $1,572.00 | $10,917.00 | $31,320.00 |