- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $997.30 / $5,128.00 / $20,680.40
| Facility | | $997.30 | $5,128.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,961.46 / $9,172.83 / $20,286.13
| Facility | | $2,961.46 | $9,172.83 | $20,286.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $3,740.43
| Facility | | $714.97 | $870.49 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.49 / $1,131.98 / $3,280.24
| Facility | | $555.49 | $1,131.98 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $742.84 / $1,015.72 / $1,092.77
| Facility | | $742.84 | $1,015.72 | $1,092.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.72 / $745.37 / $2,961.46
| Facility | | $720.72 | $745.37 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.17 / $9,167.59 / $17,546.59
| Facility | | $5,948.17 | $9,167.59 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $2,408.00 / $10,522.00
| Facility | | $1,547.00 | $2,408.00 | $10,522.00 |