- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.37 / $105.37 / $120.59
| Facility | | $105.37 | $105.37 | $120.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,654.00 / $12,271.00 / $12,297.00
| Facility | | $8,654.00 | $12,271.00 | $12,297.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.33 / $161.33 / $161.33
| Facility | | $161.33 | $161.33 | $161.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.45 / $255.00 / $7,500.00
| Facility | | $109.45 | $255.00 | $7,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $3,233.00 / $11,343.00
| Facility | | $1,185.00 | $3,233.00 | $11,343.00 |