- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.69 / $1,684.26 / $7,212.00
| Facility | | $115.69 | $1,684.26 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.20 / $211.20 / $407.62
| Facility | | $211.20 | $211.20 | $407.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.52 / $138.47 / $159.78
| Facility | | $106.52 | $138.47 | $159.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.99 / $133.99 / $761.00
| Facility | | $133.99 | $133.99 | $761.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $2,174.00 / $4,426.00
| Facility | | $500.00 | $2,174.00 | $4,426.00 |