- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.86 / $463.19 / $14,516.00
| Facility | | $291.86 | $463.19 | $14,516.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,053.00 / $28,053.00 / $28,053.00
| Facility | | $28,053.00 | $28,053.00 | $28,053.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.86 / $361.30 / $625.52
| Facility | | $291.86 | $361.30 | $625.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,728.00 / $3,733.00 / $6,543.00
| Facility | | $1,728.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,153.40 / $1,408.99
| Facility | | $55.00 | $1,153.40 | $1,408.99 |