- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.91 / $4,701.00 / $7,857.02
| Facility | | $657.91 | $4,701.00 | $7,857.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,261.45 / $9,837.79 / $20,505.30
| Facility | | $3,261.45 | $9,837.79 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,776.33 / $2,519.06 / $6,059.95
| Facility | | $1,776.33 | $2,519.06 | $6,059.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,444.03 / $2,303.03 / $4,771.60
| Facility | | $1,444.03 | $2,303.03 | $4,771.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $986.44 / $1,859.28 / $10,831.00
| Facility | | $986.44 | $1,859.28 | $10,831.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |