- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.21 / $4,432.00 / $10,007.58
| Facility | | $729.21 | $4,432.00 | $10,007.58 |
- 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
- $3,451.60 / $6,672.19 / $11,949.49
| Facility | | $3,451.60 | $6,672.19 | $11,949.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.41 / $4,543.00 / $10,094.90
| Facility | | $818.41 | $4,543.00 | $10,094.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.12 / $976.12 / $976.12
| Facility | | $976.12 | $976.12 | $976.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.81 / $564.71 / $750.94
| Facility | | $430.81 | $564.71 | $750.94 |
- 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 |