- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.11 / $9,062.00 / $16,467.00
| Facility | | $527.11 | $9,062.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,531.58 / $10,927.34 / $20,194.91
| Facility | | $4,531.58 | $10,927.34 | $20,194.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,639.40 / $3,639.40 / $4,676.68
| Facility | | $3,639.40 | $3,639.40 | $4,676.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.43 / $3,400.43 / $5,444.18
| Facility | | $425.43 | $3,400.43 | $5,444.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |