- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.56 / $416.00 / $8,229.00
| Facility | | $146.56 | $416.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,014.00 / $8,584.00 / $11,253.00
| Facility | | $4,014.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.54 / $194.28 / $224.11
| Facility | | $141.54 | $194.28 | $224.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.52 / $167.52 / $167.52
| Facility | | $167.52 | $167.52 | $167.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |