- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $876.64 / $6,398.00 / $18,005.16
| Facility | | $876.64 | $6,398.00 | $18,005.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,437.10 / $16,192.78 / $36,581.76
| Facility | | $4,437.10 | $16,192.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,327.17 / $3,300.22 / $7,939.14
| Facility | | $2,327.17 | $3,300.22 | $7,939.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,891.83 / $3,017.20 / $6,251.29
| Facility | | $1,891.83 | $3,017.20 | $6,251.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,271.07 / $2,682.33 / $12,051.00
| Facility | | $1,271.07 | $2,682.33 | $12,051.00 |
- 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 |