- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $809.58 / $3,950.34 / $7,859.00
| Facility | | $809.58 | $3,950.34 | $7,859.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,673.77 / $9,076.59 / $20,505.30
| Facility | | $1,673.77 | $9,076.59 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,149.46 / $3,048.20 / $7,332.85
| Facility | | $2,149.46 | $3,048.20 | $7,332.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,747.35 / $2,786.78 / $5,773.90
| Facility | | $1,747.35 | $2,786.78 | $5,773.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,196.89 / $1,805.05 / $13,489.49
| Facility | | $1,196.89 | $1,805.05 | $13,489.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |