- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $817.70 / $5,128.00 / $20,680.40
| Facility | | $817.70 | $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
- $474.14 / $959.56 / $3,280.24
| Facility | | $474.14 | $959.56 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.73 / $860.28 / $898.47
| Facility | | $625.73 | $860.28 | $898.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.40 / $612.84 / $2,961.46
| Facility | | $603.40 | $612.84 | $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 |