- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.86 / $2,318.00 / $16,233.27
| Facility | | $238.86 | $2,318.00 | $16,233.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $5,757.57 / $8,388.00
| Facility | | $800.00 | $5,757.57 | $8,388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.74 / $297.36 / $474.16
| Facility | | $228.74 | $297.36 | $474.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.77 / $356.77 / $761.00
| Facility | | $356.77 | $356.77 | $761.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,027.00 / $5,242.00
| Facility | | $1,000.00 | $3,027.00 | $5,242.00 |