- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.88 / $276.73 / $3,740.00
| Facility | | $106.88 | $276.73 | $3,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,010.00 / $2,045.00 / $2,978.00
| Facility | | $1,010.00 | $2,045.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.24 / $136.02 / $155.46
| Facility | | $96.24 | $136.02 | $155.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.97 / $178.77 / $1,117.44
| Facility | | $70.97 | $178.77 | $1,117.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |