- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.30 / $1,478.61 / $2,168.00
| Facility | | $209.30 | $1,478.61 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $17,120.82 / $43,765.58
| Facility | | $0.98 | $17,120.82 | $43,765.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,208.18 / $4,549.60 / $10,944.69
| Facility | | $3,208.18 | $4,549.60 | $10,944.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,526.13 / $4,159.43 / $8,617.86
| Facility | | $2,526.13 | $4,159.43 | $8,617.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.53 / $2,196.75 / $10,831.00
| Facility | | $332.53 | $2,196.75 | $10,831.00 |
- 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 |