- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.98 / $3,627.00 / $13,648.37
| Facility | | $677.98 | $3,627.00 | $13,648.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.81 / $766.81 / $766.81
| Facility | | $766.81 | $766.81 | $766.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,935.66 / $19,178.63 / $25,140.99
| Facility | | $2,935.66 | $19,178.63 | $25,140.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,035.00 / $9,534.00
| Facility | | $832.00 | $4,035.00 | $9,534.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.81 / $766.81 / $766.81
| Facility | | $766.81 | $766.81 | $766.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.54 / $650.54 / $862.96
| Facility | | $650.54 | $650.54 | $862.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |