- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $3,090.30 / $11,220.18
| Facility | | $371.54 | $3,090.30 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $14,791.08 / $28,840.32
| Facility | | $2,238.72 | $14,791.08 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $2,630.27 / $10,000.00
| Facility | | $407.38 | $2,630.27 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $977.24
| Facility | | $302.00 | $302.00 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $416.87 / $741.31
| Facility | | $177.83 | $416.87 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,168.69 / $11,481.54
| Facility | | $2,089.30 | $4,168.69 | $11,481.54 |