- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $809.56 / $2,043.73 / $16,398.00
| Facility | | $809.56 | $2,043.73 | $16,398.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,087.92 / $9,167.59 / $17,907.41
| Facility | | $2,087.92 | $9,167.59 | $17,907.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,877.15 / $2,285.42 / $3,740.43
| Facility | | $1,877.15 | $2,285.42 | $3,740.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.75 / $980.47 / $2,806.97
| Facility | | $522.75 | $980.47 | $2,806.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.64 / $1,180.54 / $1,341.34
| Facility | | $740.64 | $1,180.54 | $1,341.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $893.32 / $914.91 / $2,961.46
| Facility | | $893.32 | $914.91 | $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 |