- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.88 / $3,776.00 / $9,727.00
| Facility | | $101.88 | $3,776.00 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $784.48 / $1,806.69 / $4,098.22
| Facility | | $784.48 | $1,806.69 | $4,098.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.47 / $780.00 / $781.44
| Facility | | $146.47 | $780.00 | $781.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.88 / $173.20 / $277.42
| Facility | | $101.88 | $173.20 | $277.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $3,866.00 / $6,584.00
| Facility | | $490.00 | $3,866.00 | $6,584.00 |