- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.17 / $2,066.21 / $16,467.00
| Facility | | $91.17 | $2,066.21 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $906.57 / $2,518.04 / $5,322.64
| Facility | | $906.57 | $2,518.04 | $5,322.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.94 / $580.00 / $781.44
| Facility | | $86.94 | $580.00 | $781.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.58 / $148.07 / $260.00
| Facility | | $78.58 | $148.07 | $260.00 |
- 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 |