- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $621.39 / $8,069.20 / $18,711.00
| Facility | | $621.39 | $8,069.20 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,844.03 / $19,056.41 / $38,781.51
| Facility | | $6,844.03 | $19,056.41 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $11,632.78
| Facility | | $714.97 | $870.49 | $11,632.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.76 / $7,222.42 / $15,896.43
| Facility | | $476.76 | $7,222.42 | $15,896.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.23 / $9,591.50 / $11,955.48
| Facility | | $716.23 | $9,591.50 | $11,955.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,917.22 / $6,844.03 / $8,759.70
| Facility | | $2,917.22 | $6,844.03 | $8,759.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,146.66 / $20,262.22 / $38,781.51
| Facility | | $13,146.66 | $20,262.22 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $5,547.00 / $19,271.00
| Facility | | $3,028.00 | $5,547.00 | $19,271.00 |