- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $765.07 / $2,769.52 / $18,711.00
| Facility | | $765.07 | $2,769.52 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,218.36 / $8,052.47 / $15,403.47
| Facility | | $2,218.36 | $8,052.47 | $15,403.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $2,846.84
| Facility | | $466.83 | $568.48 | $2,846.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.29 / $832.30 / $2,496.58
| Facility | | $406.29 | $832.30 | $2,496.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.29 / $765.14 / $840.85
| Facility | | $553.29 | $765.14 | $840.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.49 / $573.54 / $2,218.36
| Facility | | $549.49 | $573.54 | $2,218.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,221.67 / $8,047.87 / $15,403.47
| Facility | | $5,221.67 | $8,047.87 | $15,403.47 |
- 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 |