- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $693.27 / $4,011.00 / $18,711.00
| Facility | | $693.27 | $4,011.00 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,264.85 / $8,047.87 / $15,720.23
| Facility | | $3,264.85 | $8,047.87 | $15,720.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $2,846.84
| Facility | | $625.25 | $761.81 | $2,846.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.87 / $1,183.91 / $2,496.58
| Facility | | $572.87 | $1,183.91 | $2,496.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.26 / $1,039.83 / $1,106.17
| Facility | | $771.26 | $1,039.83 | $1,106.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $733.86 / $738.78 / $2,218.36
| Facility | | $733.86 | $738.78 | $2,218.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,221.67 / $8,047.87 / $15,403.47
| Facility | | $5,221.67 | $8,047.87 | $15,403.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.00 / $1,436.00 / $6,857.00
| Facility | | $702.00 | $1,436.00 | $6,857.00 |