- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.48 / $285.47 / $8,229.00
| Facility | | $254.48 | $285.47 | $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
- $265.16 / $363.33 / $419.12
| Facility | | $265.16 | $363.33 | $419.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.48 / $316.27 / $316.27
| Facility | | $261.48 | $316.27 | $316.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $3,176.00
| Facility | | $50.00 | $597.00 | $3,176.00 |