- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $811.68 / $6,259.76 / $17,930.00
| Facility | | $811.68 | $6,259.76 | $17,930.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,961.46 / $9,172.83 / $17,546.59
| Facility | | $2,961.46 | $9,172.83 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $3,740.43
| Facility | | $625.25 | $761.81 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.05 / $922.27 / $3,280.24
| Facility | | $448.05 | $922.27 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $610.04 / $935.55 / $1,139.67
| Facility | | $610.04 | $935.55 | $1,139.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $751.53 / $777.36 / $2,961.46
| Facility | | $751.53 | $777.36 | $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
- $702.00 / $1,436.00 / $6,857.00
| Facility | | $702.00 | $1,436.00 | $6,857.00 |