- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.35 / $5,128.00 / $20,680.40
| Facility | | $921.35 | $5,128.00 | $20,680.40 |
- 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
- $543.32 / $1,105.08 / $3,280.24
| Facility | | $543.32 | $1,105.08 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $721.28 / $976.86 / $1,027.48
| Facility | | $721.28 | $976.86 | $1,027.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $684.48 / $695.55 / $2,961.46
| Facility | | $684.48 | $695.55 | $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
- $1,547.00 / $2,408.00 / $10,522.00
| Facility | | $1,547.00 | $2,408.00 | $10,522.00 |