- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.27 / $633.76 / $5,634.00
| Facility | | $100.27 | $633.76 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,840.00 / $7,747.00
| Facility | | $1,682.00 | $3,840.00 | $7,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.43 / $130.44 / $233.84
| Facility | | $97.43 | $130.44 | $233.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.77 / $356.73 / $1,375.01
| Facility | | $178.77 | $356.73 | $1,375.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,399.00 / $5,995.00 / $10,413.00
| Facility | | $1,399.00 | $5,995.00 | $10,413.00 |