- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.12 / $8,205.04 / $18,711.00
| Facility | | $629.12 | $8,205.04 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,961.46 / $9,172.83 / $20,286.13
| Facility | | $2,961.46 | $9,172.83 | $20,286.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $3,740.43
| Facility | | $714.97 | $870.49 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.85 / $768.61 / $3,280.24
| Facility | | $388.85 | $768.61 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.69 / $673.28 / $702.16
| Facility | | $509.69 | $673.28 | $702.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.72 / $478.94 / $2,961.46
| Facility | | $455.72 | $478.94 | $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
- $1,547.00 / $2,408.00 / $10,522.00
| Facility | | $1,547.00 | $2,408.00 | $10,522.00 |