- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.51 / $1,213.38 / $17,100.00
| Facility | | $544.51 | $1,213.38 | $17,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,397.92 / $9,172.83 / $17,546.59
| Facility | | $1,397.92 | $9,172.83 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $3,740.43
| Facility | | $625.25 | $761.81 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.87 / $692.65 / $2,806.97
| Facility | | $371.87 | $692.65 | $2,806.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.38 / $837.50 / $934.65
| Facility | | $541.38 | $837.50 | $934.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.10 / $637.52 / $2,961.46
| Facility | | $611.10 | $637.52 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,646.13 / $9,167.59 / $17,546.59
| Facility | | $5,646.13 | $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 |