- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.31 / $6,781.00 / $18,730.18
| Facility | | $750.31 | $6,781.00 | $18,730.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,521.55 / $16,192.78 / $36,581.76
| Facility | | $1,521.55 | $16,192.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,988.59 / $2,820.06 / $6,784.04
| Facility | | $1,988.59 | $2,820.06 | $6,784.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,616.58 / $2,578.21 / $5,341.76
| Facility | | $1,616.58 | $2,578.21 | $5,341.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.67 / $2,321.56 / $12,051.00
| Facility | | $1,258.67 | $2,321.56 | $12,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,658.00 / $8,582.00 / $12,774.00
| Facility | | $5,658.00 | $8,582.00 | $12,774.00 |