- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $558.98 / $4,500.00 / $17,100.00
| Facility | | $558.98 | $4,500.00 | $17,100.00 |
- 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
- $431.08 / $890.20 / $3,280.24
| Facility | | $431.08 | $890.20 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.55 / $802.66 / $877.70
| Facility | | $576.55 | $802.66 | $877.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.66 / $598.66 / $2,961.46
| Facility | | $576.66 | $598.66 | $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 |