- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.53 / $5,116.62 / $18,800.00
| Facility | | $900.53 | $5,116.62 | $18,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,264.85 / $8,052.47 / $17,808.41
| Facility | | $3,264.85 | $8,052.47 | $17,808.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $2,846.84
| Facility | | $714.97 | $870.49 | $2,846.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $751.68 / $1,520.32 / $2,467.12
| Facility | | $751.68 | $1,520.32 | $2,467.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.96 / $1,396.67 / $1,425.28
| Facility | | $1,030.96 | $1,396.67 | $1,425.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $738.78 / $949.49 / $2,218.36
| Facility | | $738.78 | $949.49 | $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
- $702.00 / $1,436.00 / $6,857.00
| Facility | | $702.00 | $1,436.00 | $6,857.00 |