- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.19 / $6,020.60 / $6,659.00
| Facility | | $415.19 | $6,020.60 | $6,659.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,159.75 / $15,647.88 / $36,247.94
| Facility | | $2,159.75 | $15,647.88 | $36,247.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,481.52 / $21,041.17 / $50,617.37
| Facility | | $13,481.52 | $21,041.17 | $50,617.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,819.75 / $18,551.41 / $39,856.19
| Facility | | $10,819.75 | $18,551.41 | $39,856.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.62 / $5,487.27 / $16,400.41
| Facility | | $537.62 | $5,487.27 | $16,400.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,437.00 / $9,370.00 / $12,774.00
| Facility | | $3,437.00 | $9,370.00 | $12,774.00 |