- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $819.07 / $5,128.00 / $20,680.40
| Facility | | $819.07 | $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
- $489.82 / $991.24 / $3,280.24
| Facility | | $489.82 | $991.24 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.62 / $840.18 / $897.80
| Facility | | $627.62 | $840.18 | $897.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $589.80 / $612.38 / $2,961.46
| Facility | | $589.80 | $612.38 | $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
- $2,155.00 / $3,129.00 / $11,941.00
| Facility | | $2,155.00 | $3,129.00 | $11,941.00 |