- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $836.31 / $1,538.00 / $8,409.74
| Facility | | $836.31 | $1,538.00 | $8,409.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,919.15 / $8,480.52 / $18,388.81
| Facility | | $3,919.15 | $8,480.52 | $18,388.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,218.52 / $3,146.14 / $7,568.47
| Facility | | $2,218.52 | $3,146.14 | $7,568.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,803.50 / $2,876.33 / $5,959.43
| Facility | | $1,803.50 | $2,876.33 | $5,959.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,251.90 / $2,305.82 / $12,365.45
| Facility | | $1,251.90 | $2,305.82 | $12,365.45 |
- 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 |