- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.87 / $834.00 / $11,093.00
| Facility | | $153.87 | $834.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,140.00 / $5,958.00 / $9,462.00
| Facility | | $2,140.00 | $5,958.00 | $9,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.44 / $185.17 / $351.77
| Facility | | $142.44 | $185.17 | $351.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.06 / $615.00 / $1,873.52
| Facility | | $270.06 | $615.00 | $1,873.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,817.00 / $5,402.00
| Facility | | $900.00 | $3,817.00 | $5,402.00 |