- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $772.83 / $1,539.38 / $17,100.00
| Facility | | $772.83 | $1,539.38 | $17,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.68 / $8,052.47 / $16,394.00
| Facility | | $1,967.68 | $8,052.47 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $2,846.84
| Facility | | $625.25 | $761.81 | $2,846.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.33 / $932.79 / $2,136.38
| Facility | | $497.33 | $932.79 | $2,136.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $744.32 / $1,102.15 / $1,193.27
| Facility | | $744.32 | $1,102.15 | $1,193.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $738.78 / $788.67 / $2,218.36
| Facility | | $738.78 | $788.67 | $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 |