- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $3,801.89 / $6,165.95
| Facility | | $251.19 | $3,801.89 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $9,772.37 / $22,387.21
| Facility | | $5,623.41 | $9,772.37 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,000.00 / $2,398.83
| Facility | | $707.95 | $1,000.00 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $954.99 / $1,862.09
| Facility | | $776.25 | $954.99 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $691.83 / $8,317.64
| Facility | | $371.54 | $691.83 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $12,589.25
| Facility | | $2,884.03 | $5,248.07 | $12,589.25 |