- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $991.03 / $10,416.92 / $60,823.00
| Facility | | $991.03 | $10,416.92 | $60,823.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,317.56 / $13,486.80 / $24,249.90
| Facility | | $4,317.56 | $13,486.80 | $24,249.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,510.26 / $7,510.26 / $9,650.82
| Facility | | $7,510.26 | $7,510.26 | $9,650.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.17 / $590.19 / $868.63
| Facility | | $388.17 | $590.19 | $868.63 |
- 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 |