- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.43 / $9,421.61 / $20,680.40
| Facility | | $787.43 | $9,421.61 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.92 / $25,035.29 / $55,801.25
| Facility | | $3,496.92 | $25,035.29 | $55,801.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,008.84 / $10,008.84 / $16,674.59
| Facility | | $10,008.84 | $10,008.84 | $16,674.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $759.73 / $8,055.97 / $16,613.43
| Facility | | $759.73 | $8,055.97 | $16,613.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.24 / $9,087.57 / $10,534.27
| Facility | | $852.24 | $9,087.57 | $10,534.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,546.64 / $6,505.85 / $6,955.36
| Facility | | $3,546.64 | $6,505.85 | $6,955.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,785.40 / $27,419.55 / $55,801.25
| Facility | | $12,785.40 | $27,419.55 | $55,801.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,075.00 / $9,912.10 / $19,271.00
| Facility | | $4,075.00 | $9,912.10 | $19,271.00 |