- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.06 / $3,589.00 / $8,427.00
| Facility | | $918.06 | $3,589.00 | $8,427.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.51 / $1,030.51 / $1,030.51
| Facility | | $1,030.51 | $1,030.51 | $1,030.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,412.73 / $10,412.73 / $12,245.44
| Facility | | $10,412.73 | $10,412.73 | $12,245.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.06 / $4,122.00 / $8,427.00
| Facility | | $918.06 | $4,122.00 | $8,427.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.51 / $1,030.51 / $1,030.51
| Facility | | $1,030.51 | $1,030.51 | $1,030.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $880.98 / $880.98 / $902.38
| Facility | | $880.98 | $880.98 | $902.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $9,631.00
| Facility | | $2,468.00 | $4,563.00 | $9,631.00 |