- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $942.05 / $6,431.54 / $20,680.40
| Facility | | $942.05 | $6,431.54 | $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
- $552.00 / $1,090.64 / $3,280.24
| Facility | | $552.00 | $1,090.64 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.04 / $954.08 / $1,031.13
| Facility | | $720.04 | $954.08 | $1,031.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.14 / $703.32 / $2,961.46
| Facility | | $678.14 | $703.32 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,693.27 / $9,167.59 / $17,546.59
| Facility | | $6,693.27 | $9,167.59 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,950.00 / $3,492.00 / $11,941.00
| Facility | | $1,950.00 | $3,492.00 | $11,941.00 |