- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.06 / $8,477.27 / $20,928.72
| Facility | | $760.06 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,921.80 / $10,419.34 / $20,154.36
| Facility | | $7,921.80 | $10,419.34 | $20,154.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.06 / $1,365.39 / $4,860.64
| Facility | | $760.06 | $1,365.39 | $4,860.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,004.61 / $1,871.74 / $2,645.67
| Facility | | $1,004.61 | $1,871.74 | $2,645.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,939.00 / $8,158.00 / $9,496.00
| Facility | | $6,939.00 | $8,158.00 | $9,496.00 |