- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $434.52 / $4,886.00 / $16,467.00
| Facility | | $434.52 | $4,886.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,547.21 / $5,688.83 / $10,970.79
| Facility | | $2,547.21 | $5,688.83 | $10,970.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,048.92 / $2,048.92 / $2,632.90
| Facility | | $2,048.92 | $2,048.92 | $2,632.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.41 / $517.29 / $792.32
| Facility | | $380.41 | $517.29 | $792.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $696.53 / $868.92 / $990.69
| Facility | 50 | $696.53 | $868.92 | $990.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $10,878.00 / $16,901.00
| Facility | | $1,981.00 | $10,878.00 | $16,901.00 |