- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $1,000.00 / $3,890.45
| Facility | | $147.91 | $1,000.00 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $10,715.19 / $11,220.18
| Facility | | $3,801.89 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $194.98 / $269.15
| Facility | | $138.04 | $194.98 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $263.03 / $295.12
| Facility | | $34.67 | $263.03 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $954.99 / $3,388.44
| Facility | | $389.05 | $954.99 | $3,388.44 |