- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $281.84 / $5,011.87
| Facility | | $281.84 | $281.84 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $13,803.84 / $41,686.94
| Facility | | $7,762.47 | $13,803.84 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,047.13 / $2,511.89
| Facility | | $741.31 | $1,047.13 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,000.00 / $1,949.84
| Facility | | $794.33 | $1,000.00 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $575.44 / $11,748.98
| Facility | | $346.74 | $575.44 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $8,709.64 / $15,135.61
| Facility | | $1,584.89 | $8,709.64 | $15,135.61 |