- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.15 / $8,878.56 / $18,736.00
| Facility | | $488.15 | $8,878.56 | $18,736.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.60 / $2,571.28 / $26,542.00
| Facility | | $365.60 | $2,571.28 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.20 / $940.00 / $1,075.31
| Facility | | $883.20 | $940.00 | $1,075.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.50 / $522.21 / $674.85
| Facility | | $262.50 | $522.21 | $674.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.72 / $517.24 / $536.00
| Facility | | $383.72 | $517.24 | $536.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $359.23 / $359.23 / $365.60
| Facility | | $359.23 | $359.23 | $365.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,738.60 / $2,738.60 / $3,450.22
| Facility | | $2,738.60 | $2,738.60 | $3,450.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $546.00 / $5,793.00
| Facility | | $157.00 | $546.00 | $5,793.00 |