- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,818.38 / $10,471.29
| Facility | | $776.25 | $2,818.38 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $10,715.19 / $12,882.50
| Facility | | $8,128.31 | $10,715.19 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,000.00 / $1,202.26
| Facility | | $724.44 | $1,000.00 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $891.25 / $1,348.96
| Facility | | $34.67 | $891.25 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,890.45 / $8,511.38
| Facility | | $741.31 | $3,890.45 | $8,511.38 |