- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $3,388.44 / $5,754.40
| Facility | | $44.67 | $3,388.44 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $123.03
| Facility | | $100.00 | $100.00 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $162.18 / $1,318.26
| Facility | | $162.18 | $162.18 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,623.41 / $10,964.78
| Facility | | $2,041.74 | $5,623.41 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $4,365.16
| Facility | | $691.83 | $691.83 | $4,365.16 |