- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,187.76 / $3,801.89
| Facility | | $851.14 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,000.00 / $4,168.69
| Facility | | $56.23 | $1,000.00 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $467.74
| Facility | | $199.53 | $199.53 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $251.19 / $7,079.46
| Facility | | $154.88 | $251.19 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,023.29 / $4,168.69
| Facility | | $56.23 | $1,023.29 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |