- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $186.21 / $478.63
| Facility | | $120.23 | $186.21 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $89.13 / $100.00
| Facility | | $61.66 | $89.13 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $7,244.36 / $15,135.61
| Facility | | $2,290.87 | $7,244.36 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $676.08 / $1,412.54
| Facility | | $269.15 | $676.08 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $194.98 / $316.23
| Facility | | $117.49 | $194.98 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,760.83 / $15,135.61
| Facility | | $1,819.70 | $6,760.83 | $15,135.61 |