- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.72 / $395.28 / $8,229.00
| Facility | | $200.72 | $395.28 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,066.00
| Facility | | $1,258.00 | $2,316.00 | $4,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.02 / $269.05 / $310.37
| Facility | | $196.02 | $269.05 | $310.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.61 / $353.61 / $353.61
| Facility | | $353.61 | $353.61 | $353.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.00 / $100.00 / $3,176.00
| Facility | | $59.00 | $100.00 | $3,176.00 |