- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $827.27 / $2,769.52 / $18,711.00
| Facility | | $827.27 | $2,769.52 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.04 / $8,957.00 / $17,546.59
| Facility | | $597.04 | $8,957.00 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $568.48 / $3,740.43
| Facility | | $500.00 | $568.48 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.68 / $905.39 / $2,967.52
| Facility | | $415.68 | $905.39 | $2,967.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $610.54 / $833.48 / $911.20
| Facility | | $610.54 | $833.48 | $911.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.04 / $621.52 / $2,961.46
| Facility | | $597.04 | $621.52 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,646.13 / $9,167.59 / $17,546.59
| Facility | | $5,646.13 | $9,167.59 | $17,546.59 |
- 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 |