- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.79 / $5,192.00 / $9,062.00
| Facility | | $147.79 | $5,192.00 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,053.67 / $2,773.46 / $4,709.47
| Facility | | $1,053.67 | $2,773.46 | $4,709.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.30 / $570.00 / $1,438.20
| Facility | | $119.30 | $570.00 | $1,438.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.71 / $149.00 / $203.86
| Facility | | $112.71 | $149.00 | $203.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |