- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.94 / $2,907.35 / $6,575.00
| Facility | | $323.94 | $2,907.35 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.43 / $9,232.28 / $20,505.30
| Facility | | $679.43 | $9,232.28 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,071.65 / $10,028.48 / $24,124.86
| Facility | | $7,071.65 | $10,028.48 | $24,124.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,748.74 / $9,168.43 / $18,995.95
| Facility | | $5,748.74 | $9,168.43 | $18,995.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.46 / $4,834.62 / $10,301.40
| Facility | | $547.46 | $4,834.62 | $10,301.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,733.00 / $8,467.00 / $12,722.00
| Facility | | $4,733.00 | $8,467.00 | $12,722.00 |