- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.32 / $3,456.71 / $6,575.00
| Facility | | $444.32 | $3,456.71 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.66 / $9,232.28 / $20,505.30
| Facility | | $2,089.66 | $9,232.28 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,769.04 / $11,017.47 / $26,504.01
| Facility | | $7,769.04 | $11,017.47 | $26,504.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,315.67 / $10,072.61 / $20,869.30
| Facility | | $6,315.67 | $10,072.61 | $20,869.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.00 / $4,488.66 / $9,370.00
| Facility | | $584.00 | $4,488.66 | $9,370.00 |
- 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 |