- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.74 / $3,891.68 / $9,587.00
| Facility | | $431.74 | $3,891.68 | $9,587.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,748.20 / $16,192.78 / $36,581.76
| Facility | | $2,748.20 | $16,192.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,455.26 / $13,408.73 / $32,256.51
| Facility | | $9,455.26 | $13,408.73 | $32,256.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,686.44 / $12,258.79 / $25,398.83
| Facility | | $7,686.44 | $12,258.79 | $25,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.95 / $6,182.21 / $11,890.00
| Facility | | $717.95 | $6,182.21 | $11,890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |