- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.64 / $117.64 / $5,356.19
| Facility | | $117.64 | $117.64 | $5,356.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,478.60 / $8,452.94 / $16,482.62
| Facility | | $6,478.60 | $8,452.94 | $16,482.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.52 / $2,730.94 / $7,772.00
| Facility | | $223.52 | $2,730.94 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.34 / $372.66 / $1,671.41
| Facility | | $177.34 | $372.66 | $1,671.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |