- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.11 / $4,241.22 / $12,036.14
| Facility | | $724.11 | $4,241.22 | $12,036.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,828.40 / $10,296.48 / $19,916.72
| Facility | | $7,828.40 | $10,296.48 | $19,916.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.47 / $174.77 / $4,317.00
| Facility | | $94.47 | $174.77 | $4,317.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.98 / $242.35 / $339.98
| Facility | | $125.98 | $242.35 | $339.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |