- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.16 / $9,062.00 / $11,030.21
| Facility | | $466.16 | $9,062.00 | $11,030.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,226.87 / $10,138.79 / $17,019.66
| Facility | | $4,226.87 | $10,138.79 | $17,019.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.25 / $505.00 / $7,008.57
| Facility | | $453.25 | $505.00 | $7,008.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.08 / $568.49 / $876.96
| Facility | | $444.08 | $568.49 | $876.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |