- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.94 / $206.32 / $8,229.00
| Facility | | $141.94 | $206.32 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,503.33 / $8,650.50 / $13,595.06
| Facility | | $4,503.33 | $8,650.50 | $13,595.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.63 / $187.88 / $216.73
| Facility | | $137.63 | $187.88 | $216.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.38 / $165.38 / $165.38
| Facility | | $165.38 | $165.38 | $165.38 |
- 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 |