- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $401.00 / $8,042.03 / $19,276.96
| Facility | | $401.00 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,609.82 / $6,063.17 / $11,728.12
| Facility | | $4,609.82 | $6,063.17 | $11,728.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.85 / $1,802.85 / $1,802.85
| Facility | | $1,802.85 | $1,802.85 | $1,802.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.83 / $461.15 / $1,577.40
| Facility | | $242.83 | $461.15 | $1,577.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.74 / $941.04 / $2,163.42
| Facility | | $491.74 | $941.04 | $2,163.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,362.61 / $5,356.00 / $7,934.00
| Facility | | $2,362.61 | $5,356.00 | $7,934.00 |