- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $2,238.72 / $3,801.89
| Facility | | $114.82 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $954.99 / $2,951.21
| Facility | | $56.23 | $954.99 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.74 / $40.74 / $95.50
| Facility | | $40.74 | $40.74 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.15 / $83.18 / $7,079.46
| Facility | | $37.15 | $83.18 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,000.00 / $2,951.21
| Facility | | $56.23 | $1,000.00 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $2,818.38
| Facility | | $501.19 | $1,862.09 | $2,818.38 |