- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $827.31 / $4,828.00 / $30,481.44
| Facility | | $827.31 | $4,828.00 | $30,481.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,037.51 / $48,847.43 / $110,353.20
| Facility | | $4,037.51 | $48,847.43 | $110,353.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,062.69 / $2,925.17 / $7,036.90
| Facility | | $2,062.69 | $2,925.17 | $7,036.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,676.83 / $2,674.31 / $5,540.86
| Facility | | $1,676.83 | $2,674.31 | $5,540.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $835.01 / $1,672.41 / $26,931.00
| Facility | | $835.01 | $1,672.41 | $26,931.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,155.00 / $17,909.00 / $51,233.00
| Facility | | $14,155.00 | $17,909.00 | $51,233.00 |