- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.57 / $416.00 / $7,205.92
| Facility | | $175.57 | $416.00 | $7,205.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,584.00 / $10,099.00 / $11,253.00
| Facility | | $8,584.00 | $10,099.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.25 / $234.29 / $270.27
| Facility | | $171.25 | $234.29 | $270.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.92 / $204.92 / $209.70
| Facility | | $204.92 | $204.92 | $209.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $3,176.00
| Facility | | $50.00 | $597.00 | $3,176.00 |