- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.17 / $1,019.55 / $11,342.97
| Facility | | $86.17 | $1,019.55 | $11,342.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.04 / $1,124.26 / $2,469.40
| Facility | | $569.04 | $1,124.26 | $2,469.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.08 / $580.00 / $994.68
| Facility | | $83.08 | $580.00 | $994.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.95 / $133.56 / $237.00
| Facility | | $80.95 | $133.56 | $237.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $146.81 / $285.13 / $355.50
| Facility | 50 | $146.81 | $285.13 | $355.50 |
- 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 |