- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $7,943.28 / $20,892.96
| Facility | | $912.01 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $933.25 / $3,715.35
| Facility | | $891.25 | $933.25 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,000.00 / $4,265.80
| Facility | | $512.86 | $1,000.00 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $912.01 / $977.24
| Facility | | $758.58 | $912.01 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $660.69 / $977.24
| Facility | | $645.65 | $660.69 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $9,120.11 / $17,378.01
| Facility | | $6,760.83 | $9,120.11 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $11,220.18 / $18,620.87
| Facility | | $2,454.71 | $11,220.18 | $18,620.87 |