- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.81 / $225.36 / $5,320.00
| Facility | | $51.81 | $225.36 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,584.00 / $10,099.00 / $11,253.00
| Facility | | $8,584.00 | $10,099.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.78 / $78.65 / $98.32
| Facility | | $54.78 | $78.65 | $98.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.37 / $103.37 / $103.37
| Facility | | $103.37 | $103.37 | $103.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $668.00 / $3,176.00
| Facility | | $50.00 | $668.00 | $3,176.00 |