- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.23 / $3,925.18 / $18,711.00
| Facility | | $353.23 | $3,925.18 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.83 / $9,975.20 / $20,300.41
| Facility | | $261.83 | $9,975.20 | $20,300.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,289.46 / $2,289.46 / $3,814.21
| Facility | | $2,289.46 | $2,289.46 | $3,814.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.50 / $465.70 / $5,738.53
| Facility | | $280.50 | $465.70 | $5,738.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.13 / $377.50 / $408.03
| Facility | | $283.13 | $377.50 | $408.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.83 / $265.06 / $1,366.31
| Facility | | $261.83 | $265.06 | $1,366.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,881.70 / $10,606.39 / $20,300.41
| Facility | | $6,881.70 | $10,606.39 | $20,300.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,297.00 / $12,835.00
| Facility | | $2,155.00 | $3,297.00 | $12,835.00 |