- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.46 / $4,239.72 / $4,828.00
| Facility | | $387.46 | $4,239.72 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,026.09 / $9,232.28 / $20,505.30
| Facility | | $2,026.09 | $9,232.28 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,959.49 / $15,028.38 / $36,152.80
| Facility | | $8,959.49 | $15,028.38 | $36,152.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,727.86 / $13,250.10 / $28,466.78
| Facility | | $7,727.86 | $13,250.10 | $28,466.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.14 / $3,845.92 / $11,452.83
| Facility | | $500.14 | $3,845.92 | $11,452.83 |
- 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 |