- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $863.23 / $1,812.22 / $20,053.09
| Facility | | $863.23 | $1,812.22 | $20,053.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,345.80 / $9,172.83 / $20,286.13
| Facility | | $2,345.80 | $9,172.83 | $20,286.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,394.89 / $1,698.13 / $3,740.43
| Facility | | $1,394.89 | $1,698.13 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.67 / $1,096.91 / $2,806.97
| Facility | | $564.67 | $1,096.91 | $2,806.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $827.23 / $1,303.82 / $1,350.05
| Facility | | $827.23 | $1,303.82 | $1,350.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $903.74 / $920.86 / $2,961.46
| Facility | | $903.74 | $920.86 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.17 / $9,167.59 / $17,546.59
| Facility | | $5,948.17 | $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 |