- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.42 / $5,621.00 / $9,870.00
| Facility | | $78.42 | $5,621.00 | $9,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,502.93 / $4,499.91 / $7,538.20
| Facility | | $1,502.93 | $4,499.91 | $7,538.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $2,106.17 / $2,706.47
| Facility | | $505.00 | $2,106.17 | $2,706.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $87.96 / $142.59
| Facility | | $63.10 | $87.96 | $142.59 |
- 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 |