- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.50 / $2,727.52 / $7,735.00
| Facility | | $131.50 | $2,727.52 | $7,735.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,393.00 / $4,120.00 / $8,836.00
| Facility | | $2,393.00 | $4,120.00 | $8,836.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.48 / $117.48 / $6,213.00
| Facility | | $117.48 | $117.48 | $6,213.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.56 / $140.56 / $4,612.43
| Facility | | $140.56 | $140.56 | $4,612.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.00 / $136.82 / $332.00
| Facility | | $87.00 | $136.82 | $332.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,965.06 / $2,965.06 / $3,009.16
| Facility | | $2,965.06 | $2,965.06 | $3,009.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.56 / $555.00 / $4,612.43
| Facility | | $140.56 | $555.00 | $4,612.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,768.94 / $4,331.00 / $8,133.00
| Facility | | $1,768.94 | $4,331.00 | $8,133.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.46 / $105.46 / $363.80
| Facility | | $105.46 | $105.46 | $363.80 |