- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.19 / $4,557.00 / $10,447.42
| Facility | | $451.19 | $4,557.00 | $10,447.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,070.69 / $4,787.28 / $10,380.54
| Facility | | $2,070.69 | $4,787.28 | $10,380.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,055.34 / $1,647.13 / $3,962.38
| Facility | | $1,055.34 | $1,647.13 | $3,962.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.55 / $1,503.11 / $3,119.99
| Facility | | $914.55 | $1,503.11 | $3,119.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.67 / $946.66 / $3,309.61
| Facility | | $503.67 | $946.66 | $3,309.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,623.00 / $4,746.00 / $8,812.00
| Facility | | $1,623.00 | $4,746.00 | $8,812.00 |