- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $849.06 / $9,062.00 / $17,872.25
| Facility | | $849.06 | $9,062.00 | $17,872.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,789.10 / $10,586.52 / $18,498.91
| Facility | | $4,789.10 | $10,586.52 | $18,498.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,081.57 / $6,081.57 / $7,814.93
| Facility | | $6,081.57 | $6,081.57 | $7,814.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $846.63 / $1,151.71 / $1,724.48
| Facility | | $846.63 | $1,151.71 | $1,724.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |