- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.21 / $643.35 / $2,525.00
| Facility | | $128.21 | $643.35 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $539.07 / $1,056.60
| Facility | | $0.98 | $539.07 | $1,056.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,166.40 / $1,956.48 / $4,706.59
| Facility | | $1,166.40 | $1,956.48 | $4,706.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,086.32 / $1,724.98 / $3,705.98
| Facility | | $1,086.32 | $1,724.98 | $3,705.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.32 / $437.25 / $1,316.95
| Facility | | $162.32 | $437.25 | $1,316.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,749.00 / $2,883.00
| Facility | | $563.00 | $1,749.00 | $2,883.00 |