- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $647.27 / $4,557.00 / $11,536.06
| Facility | | $647.27 | $4,557.00 | $11,536.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,046.47 / $12,197.67 / $25,424.06
| Facility | | $3,046.47 | $12,197.67 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,575.91 / $2,235.98 / $5,378.96
| Facility | | $1,575.91 | $2,235.98 | $5,378.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,432.64 / $2,044.22 / $4,235.39
| Facility | | $1,432.64 | $2,044.22 | $4,235.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.68 / $1,310.11 / $7,950.52
| Facility | | $671.68 | $1,310.11 | $7,950.52 |
- 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 |