- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.18 / $387.53 / $8,229.00
| Facility | | $89.18 | $387.53 | $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
- $87.88 / $120.61 / $139.13
| Facility | | $87.88 | $120.61 | $139.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.52 / $158.52 / $158.52
| Facility | | $158.52 | $158.52 | $158.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.00 / $594.00 / $3,394.00
| Facility | | $334.00 | $594.00 | $3,394.00 |