- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.71 / $3,566.00 / $9,077.00
| Facility | | $592.71 | $3,566.00 | $9,077.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,816.90 / $7,512.37 / $12,705.07
| Facility | | $3,816.90 | $7,512.37 | $12,705.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.33 / $3,803.60 / $8,632.87
| Facility | | $608.33 | $3,803.60 | $8,632.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.70 / $762.70 / $762.70
| Facility | | $762.70 | $762.70 | $762.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.67 / $438.76 / $611.39
| Facility | | $385.67 | $438.76 | $611.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |