- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.52 / $902.55 / $16,467.00
| Facility | | $390.52 | $902.55 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.01 / $5,957.93 / $11,992.48
| Facility | | $2,248.01 | $5,957.93 | $11,992.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $535.00 / $570.00
| Facility | | $100.00 | $535.00 | $570.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.73 / $643.64 / $771.75
| Facility | | $355.73 | $643.64 | $771.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.00 / $12,269.00 / $19,591.00
| Facility | | $870.00 | $12,269.00 | $19,591.00 |