- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.19 / $5,164.20 / $6,781.00
| Facility | | $758.19 | $5,164.20 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,525.74 / $8,480.52 / $17,727.40
| Facility | | $3,525.74 | $8,480.52 | $17,727.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,010.48 / $2,851.12 / $6,858.75
| Facility | | $2,010.48 | $2,851.12 | $6,858.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.38 / $2,606.60 / $5,400.59
| Facility | | $1,634.38 | $2,606.60 | $5,400.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,072.72 / $1,658.04 / $9,404.00
| Facility | | $1,072.72 | $1,658.04 | $9,404.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |