- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $811.10 / $2,747.00 / $7,263.00
| Facility | | $811.10 | $2,747.00 | $7,263.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $863.08 / $863.08 / $863.08
| Facility | | $863.08 | $863.08 | $863.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,984.85 / $2,447.48 / $14,427.62
| Facility | | $1,984.85 | $2,447.48 | $14,427.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $811.10 / $3,748.00 / $8,017.00
| Facility | | $811.10 | $3,748.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $863.08 / $863.08 / $863.08
| Facility | | $863.08 | $863.08 | $863.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.83 / $749.83 / $790.46
| Facility | | $749.83 | $749.83 | $790.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,447.00 / $3,198.00 / $6,000.00
| Facility | | $1,447.00 | $3,198.00 | $6,000.00 |