- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $948.91 / $4,241.22 / $13,841.56
| Facility | | $948.91 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,322.41 / $1,739.33 / $3,364.42
| Facility | | $1,322.41 | $1,739.33 | $3,364.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $1,099.43 / $1,661.84
| Facility | | $144.00 | $1,099.43 | $1,661.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.27 / $1,421.67 / $2,135.86
| Facility | | $269.27 | $1,421.67 | $2,135.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |