- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.61 / $2,849.00 / $10,268.00
| Facility | | $101.61 | $2,849.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.00 / $1,182.00 / $2,362.00
| Facility | | $1,182.00 | $1,182.00 | $2,362.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.26 / $68.36 / $90.80
| Facility | | $53.26 | $68.36 | $90.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- 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
- $444.00 / $965.00 / $2,914.00
| Facility | | $444.00 | $965.00 | $2,914.00 |