- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.12 / $3,526.35 / $11,408.41
| Facility | | $159.12 | $3,526.35 | $11,408.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,635.00 / $5,445.00
| Facility | | $1,636.00 | $3,635.00 | $5,445.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.19 / $191.35 / $220.79
| Facility | | $147.19 | $191.35 | $220.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.82 / $365.92 / $402.00
| Facility | | $182.82 | $365.92 | $402.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $2,174.00 / $4,426.00
| Facility | | $500.00 | $2,174.00 | $4,426.00 |