- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.55 / $193.76 / $8,229.00
| Facility | | $142.55 | $193.76 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,867.83 / $4,388.47 / $11,253.00
| Facility | | $1,867.83 | $4,388.47 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.86 / $185.09 / $213.52
| Facility | | $134.86 | $185.09 | $213.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.79 / $166.79 / $231.22
| Facility | | $166.79 | $166.79 | $231.22 |
- 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 |