- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.81 / $4,778.89 / $13,841.56
| Facility | | $132.81 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,151.05 / $1,501.83 / $2,928.46
| Facility | | $1,151.05 | $1,501.83 | $2,928.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,539.00 / $1,539.00 / $1,539.00
| Facility | | $1,539.00 | $1,539.00 | $1,539.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.33 / $216.55 / $3,453.56
| Facility | | $113.33 | $216.55 | $3,453.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.71 / $333.50 / $1,908.09
| Facility | | $222.71 | $333.50 | $1,908.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |