- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.71 / $10,122.46 / $22,024.00
| Facility | | $830.71 | $10,122.46 | $22,024.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,044.82 / $27,419.55 / $55,801.25
| Facility | | $5,044.82 | $27,419.55 | $55,801.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,946.98 / $9,946.98 / $16,571.54
| Facility | | $9,946.98 | $9,946.98 | $16,571.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $726.48 / $6,788.52 / $13,108.85
| Facility | | $726.48 | $6,788.52 | $13,108.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $902.49 / $7,030.75 / $8,661.09
| Facility | | $902.49 | $7,030.75 | $8,661.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,044.82 / $5,358.08 / $5,975.14
| Facility | | $5,044.82 | $5,358.08 | $5,975.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,916.23 / $29,070.27 / $55,801.25
| Facility | | $18,916.23 | $29,070.27 | $55,801.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $4,686.00 / $20,708.00
| Facility | | $3,028.00 | $4,686.00 | $20,708.00 |