- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.30 / $3,322.92 / $19,598.88
| Facility | | $498.30 | $3,322.92 | $19,598.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.07 / $627.35 / $941.03
| Facility | | $457.07 | $627.35 | $941.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- 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 |