- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.07 / $127.78 / $8,229.00
| Facility | | $103.07 | $127.78 | $8,229.00 |
- 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
- $98.62 / $135.35 / $159.72
| Facility | | $98.62 | $135.35 | $159.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.44 / $119.44 / $121.88
| Facility | | $119.44 | $119.44 | $121.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $11,156.00
| Facility | | $50.00 | $597.00 | $11,156.00 |