- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.74 / $2,525.00 / $5,476.66
| Facility | | $334.74 | $2,525.00 | $5,476.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,630.25 / $11,716.49 / $25,424.06
| Facility | | $1,630.25 | $11,716.49 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,690.72 / $18,246.18 / $43,893.68
| Facility | | $11,690.72 | $18,246.18 | $43,893.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,459.48 / $16,681.39 / $34,561.94
| Facility | | $10,459.48 | $16,681.39 | $34,561.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.62 / $5,392.07 / $12,367.00
| Facility | | $454.62 | $5,392.07 | $12,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |