- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,162.28 / $6,606.93
| Facility | | $1,023.29 | $3,162.28 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $21,379.62 / $29,512.09
| Facility | | $12,589.25 | $21,379.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $39.81 / $1,000.00
| Facility | | $39.81 | $39.81 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Facility | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $7,079.46 / $18,620.87
| Facility | | $1,202.26 | $7,079.46 | $18,620.87 |