- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.54 / $354.53 / $3,740.00
| Facility | | $65.54 | $354.53 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.36 / $83.41 / $98.43
| Facility | | $68.36 | $83.41 | $98.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.63 / $109.63 / $109.63
| Facility | | $109.63 | $109.63 | $109.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.00 / $1,335.00 / $11,156.00
| Facility | | $391.00 | $1,335.00 | $11,156.00 |