- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.27 / $202.14 / $8,229.00
| Facility | | $158.27 | $202.14 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,830.00 / $8,584.00 / $11,253.00
| Facility | | $5,830.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.44 / $210.60 / $242.95
| Facility | | $153.44 | $210.60 | $242.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.77 / $185.77 / $185.77
| Facility | | $185.77 | $185.77 | $185.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.00 / $100.00 / $3,176.00
| Facility | | $59.00 | $100.00 | $3,176.00 |