- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.16 / $3,500.00 / $16,042.00
| Facility | | $812.16 | $3,500.00 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,705.10 / $16,700.00 / $33,821.32
| Facility | | $2,705.10 | $16,700.00 | $33,821.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $808.34 / $1,109.49 / $1,664.24
| Facility | | $808.34 | $1,109.49 | $1,664.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,225.01 / $6,225.01 / $7,379.14
| Facility | | $6,225.01 | $6,225.01 | $7,379.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |