- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $817.29 / $8,042.03 / $19,276.96
| Facility | | $817.29 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,099.31 / $6,706.99 / $12,973.48
| Facility | | $5,099.31 | $6,706.99 | $12,973.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $736.76 / $1,430.26 / $3,726.00
| Facility | | $736.76 | $1,430.26 | $3,726.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,330.00 / $1,944.96 / $2,429.98
| Facility | | $1,330.00 | $1,944.96 | $2,429.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,723.24 / $7,772.00
| Facility | | $3,044.00 | $3,723.24 | $7,772.00 |