- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $864.11 / $6,470.00 / $18,800.00
| Facility | | $864.11 | $6,470.00 | $18,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,961.46 / $9,172.83 / $20,286.13
| Facility | | $2,961.46 | $9,172.83 | $20,286.13 |
- 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
- $554.40 / $1,108.48 / $3,280.24
| Facility | | $554.40 | $1,108.48 | $3,280.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.58 / $964.13 / $1,025.09
| Facility | | $706.58 | $964.13 | $1,025.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.69 / $699.21 / $2,961.46
| Facility | | $677.69 | $699.21 | $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
- $2,155.00 / $2,942.06 / $11,941.00
| Facility | | $2,155.00 | $2,942.06 | $11,941.00 |