- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $245.47 / $512.86
| Facility | | $141.25 | $245.47 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $89.13 / $100.00
| Facility | | $56.23 | $89.13 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $199.53 / $524.81
| Facility | | $75.86 | $199.53 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $15,848.93 / $37,153.52
| Facility | | $575.44 | $15,848.93 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.44 / $117.49 / $302.00
| Facility | | $23.44 | $117.49 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $158.49 / $158.49
| Facility | | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $186.21 / $524.81
| Facility | | $75.86 | $186.21 | $524.81 |