- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $804.88 / $1,633.69 / $17,930.00
| Facility | | $804.88 | $1,633.69 | $17,930.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,431.46 / $9,172.83 / $17,546.59
| Facility | | $2,431.46 | $9,172.83 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $3,740.43
| Facility | | $466.83 | $568.48 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.24 / $1,202.27 / $2,806.97
| Facility | | $590.24 | $1,202.27 | $2,806.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.72 / $1,171.51 / $1,278.35
| Facility | | $852.72 | $1,171.51 | $1,278.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $840.77 / $871.96 / $2,961.46
| Facility | | $840.77 | $871.96 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.17 / $9,167.59 / $17,546.59
| Facility | | $5,948.17 | $9,167.59 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.00 / $2,769.18 / $6,857.00
| Facility | | $702.00 | $2,769.18 | $6,857.00 |