- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.40 / $347.47 / $8,229.00
| Facility | | $197.40 | $347.47 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.00 / $10,099.00 / $24,626.72
| Facility | | $6,153.00 | $10,099.00 | $24,626.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.48 / $324.58 / $374.43
| Facility | | $236.48 | $324.58 | $374.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.50 / $283.50 / $283.50
| Facility | | $283.50 | $283.50 | $283.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |