- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.85 / $5,452.92 / $6,575.00
| Facility | | $443.85 | $5,452.92 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,153.23 / $15,647.88 / $36,247.94
| Facility | | $2,153.23 | $15,647.88 | $36,247.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,211.99 / $17,318.11 / $41,661.06
| Facility | | $12,211.99 | $17,318.11 | $41,661.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,927.46 / $15,832.91 / $32,803.99
| Facility | | $9,927.46 | $15,832.91 | $32,803.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.73 / $6,780.33 / $12,174.44
| Facility | | $656.73 | $6,780.33 | $12,174.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |