- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.82 / $3,925.18 / $18,711.00
| Facility | | $127.82 | $3,925.18 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.47 / $2,571.28 / $16,394.00
| Facility | | $138.47 | $2,571.28 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $670.00 / $761.81
| Facility | | $625.25 | $670.00 | $761.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.05 / $197.31 / $253.82
| Facility | | $99.05 | $197.31 | $253.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.87 / $195.54 / $204.00
| Facility | | $144.87 | $195.54 | $204.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.90 / $135.90 / $138.47
| Facility | | $135.90 | $135.90 | $138.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,773.14 / $4,773.14 / $6,013.44
| Facility | | $4,773.14 | $4,773.14 | $6,013.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $546.00 / $5,793.00
| Facility | | $157.00 | $546.00 | $5,793.00 |