- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $922.17 / $2,769.52 / $18,711.00
| Facility | | $922.17 | $2,769.52 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $690.53 / $8,957.00 / $17,546.59
| Facility | | $690.53 | $8,957.00 | $17,546.59 |
- 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
- $498.07 / $1,023.52 / $3,280.24
| Facility | | $498.07 | $1,023.52 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.65 / $928.56 / $1,012.37
| Facility | | $678.65 | $928.56 | $1,012.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.38 / $690.53 / $2,961.46
| Facility | | $661.38 | $690.53 | $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 |