- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.35 / $416.00 / $3,740.00
| Facility | | $58.35 | $416.00 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.74 / $77.70 / $91.71
| Facility | | $56.74 | $77.70 | $91.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68.22 / $68.22 / $81.06
| Facility | | $68.22 | $68.22 | $81.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $597.00 / $11,156.00
| Facility | | $50.00 | $597.00 | $11,156.00 |