- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.36 / $927.00 / $7,212.00
| Facility | | $125.36 | $927.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $5,593.00 / $8,240.00
| Facility | | $800.00 | $5,593.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.92 / $127.40 / $142.69
| Facility | | $101.92 | $127.40 | $142.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.92 / $1,178.83 / $1,178.83
| Facility | | $124.92 | $1,178.83 | $1,178.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,817.00 / $5,490.00
| Facility | | $1,000.00 | $3,817.00 | $5,490.00 |