- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,248.07 / $10,471.29
| Facility | | $977.24 | $5,248.07 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $12,302.69
| Facility | | $3,388.44 | $5,888.44 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,995.26 / $8,912.51
| Facility | | $977.24 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $50,118.72
| Facility | | $1,174.90 | $1,174.90 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $1,412.54
| Facility | 22 | $1,412.54 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,000.00 / $2,511.89
| Facility | | $758.58 | $1,000.00 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,265.80 / $8,709.64
| Facility | | $1,412.54 | $4,265.80 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $50,118.72 / $75,857.76
| Facility | | $707.95 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,128.61 / $11,481.54
| Facility | | $2,344.23 | $5,128.61 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $831.76 / $3,019.95
| Facility | | $562.34 | $831.76 | $3,019.95 |