- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $98.58 / $308.70 / $8,229.00
| Facility | | $98.58 | $308.70 | $8,229.00 |
- 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
- $96.66 / $132.68 / $153.05
| Facility | | $96.66 | $132.68 | $153.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.38 / $174.38 / $174.38
| Facility | | $174.38 | $174.38 | $174.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $794.00 / $5,301.00
| Facility | | $523.00 | $794.00 | $5,301.00 |