- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $996.91 / $7,950.75 / $18,711.00
| Facility | | $996.91 | $7,950.75 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,490.98 / $9,167.59 / $17,907.41
| Facility | | $5,490.98 | $9,167.59 | $17,907.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $3,740.43
| Facility | | $714.97 | $870.49 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.50 / $1,163.98 / $3,280.24
| Facility | | $575.50 | $1,163.98 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $757.54 / $1,035.15 / $1,098.80
| Facility | | $757.54 | $1,035.15 | $1,098.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $722.99 / $749.48 / $2,961.46
| Facility | | $722.99 | $749.48 | $2,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,145.87 / $9,167.59 / $17,546.59
| Facility | | $6,145.87 | $9,167.59 | $17,546.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,297.00 / $11,604.61 / $18,561.84
| Facility | | $3,297.00 | $11,604.61 | $18,561.84 |