- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $930.52 / $3,682.00 / $12,281.00
| Facility | | $930.52 | $3,682.00 | $12,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,557.83 / $2,661.29 / $5,489.51
| Facility | | $1,557.83 | $2,661.29 | $5,489.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $898.37 / $898.37 / $914.77
| Facility | | $898.37 | $898.37 | $914.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,857.50 / $26,542.00 / $26,542.00
| Facility | | $7,857.50 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.82 / $1,153.93 / $1,607.25
| Facility | | $926.82 | $1,153.93 | $1,607.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $930.05 / $1,157.78 / $1,692.61
| Facility | | $930.05 | $1,157.78 | $1,692.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $2,064.00 / $4,554.00
| Facility | | $597.00 | $2,064.00 | $4,554.00 |