- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.41 / $1,000.00 / $7,838.38
| Facility | | $141.41 | $1,000.00 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $930.26 / $2,292.44 / $3,738.69
| Facility | | $930.26 | $2,292.44 | $3,738.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.61 / $149.61 / $596.36
| Facility | | $149.61 | $149.61 | $596.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84.42 / $540.63 / $1,075.03
| Facility | | $84.42 | $540.63 | $1,075.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.00 / $3,085.00 / $5,060.00
| Facility | | $755.00 | $3,085.00 | $5,060.00 |