- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.81 / $135.60 / $5,320.00
| Facility | | $72.81 | $135.60 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,191.00 / $4,066.00
| Facility | | $1,258.00 | $2,191.00 | $4,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.63 / $87.21 / $101.82
| Facility | | $71.63 | $87.21 | $101.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.97 / $129.19 / $129.19
| Facility | | $72.97 | $129.19 | $129.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $1,895.00
| Facility | | $50.00 | $597.00 | $1,895.00 |