- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $7,943.28 / $20,892.96
| Facility | | $870.96 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,230.27 / $4,466.84
| Facility | | $1,000.00 | $1,230.27 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $954.99 / $4,265.80
| Facility | | $489.78 | $954.99 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $870.96 / $933.25
| Facility | | $676.08 | $870.96 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $630.96 / $977.24
| Facility | | $616.60 | $630.96 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,120.11 / $17,378.01
| Facility | | $6,165.95 | $9,120.11 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,471.29 / $18,620.87
| Facility | | $1,995.26 | $10,471.29 | $18,620.87 |