- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.54 / $373.72 / $9,727.00
| Facility | | $125.54 | $373.72 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,850.50 / $4,661.39 / $8,201.14
| Facility | | $1,850.50 | $4,661.39 | $8,201.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $1,248.31 / $1,604.11
| Facility | | $375.00 | $1,248.31 | $1,604.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.57 / $177.46 / $302.75
| Facility | | $93.57 | $177.46 | $302.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |