- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $396.81 / $593.53 / $5,320.00
| Facility | | $396.81 | $593.53 | $5,320.00 |
- 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
- $383.30 / $526.11 / $606.90
| Facility | | $383.30 | $526.11 | $606.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.27 / $461.27 / $461.27
| Facility | | $461.27 | $461.27 | $461.27 |
- 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 |