- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.55 / $3,776.00 / $12,941.00
| Facility | | $715.55 | $3,776.00 | $12,941.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,365.52 / $4,243.05 / $8,403.96
| Facility | | $2,365.52 | $4,243.05 | $8,403.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,216.00 / $2,921.45 / $4,310.50
| Facility | | $1,216.00 | $2,921.45 | $4,310.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.66 / $2,678.82 / $2,678.82
| Facility | | $457.66 | $2,678.82 | $2,678.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.64 / $843.64 / $843.64
| Facility | | $843.64 | $843.64 | $843.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,345.80 / $11,500.00 / $26,542.00
| Facility | | $2,345.80 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.14 / $681.32 / $1,095.61
| Facility | | $496.14 | $681.32 | $1,095.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.86 / $682.14 / $1,121.46
| Facility | | $496.86 | $682.14 | $1,121.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,326.00 / $7,600.00
| Facility | | $1,154.00 | $3,326.00 | $7,600.00 |