- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.25 / $4,011.00 / $18,711.00
| Facility | | $953.25 | $4,011.00 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.75 / $4,554.63 / $11,500.00
| Facility | | $2,318.75 | $4,554.63 | $11,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $1,985.59
| Facility | | $625.25 | $761.81 | $1,985.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.70 / $1,075.91 / $1,741.30
| Facility | | $530.70 | $1,075.91 | $1,741.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.09 / $966.81 / $1,044.53
| Facility | | $706.09 | $966.81 | $1,044.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.44 / $686.30 / $1,613.81
| Facility | | $537.44 | $686.30 | $1,613.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,323.45 / $4,552.03 / $8,712.50
| Facility | | $3,323.45 | $4,552.03 | $8,712.50 |
- 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 |