- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $7,413.10 / $22,908.68
| Facility | | $954.99 | $7,413.10 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $4,073.80 / $6,760.83
| Facility | | $4,073.80 | $4,073.80 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,230.27 / $15,488.17
| Facility | | $707.95 | $1,230.27 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,000.00 / $1,047.13
| Facility | | $831.76 | $1,000.00 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $707.95 / $707.95
| Facility | | $691.83 | $707.95 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,218.10 / $31,622.78
| Facility | | $10,715.19 | $16,218.10 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $20,892.96 / $36,307.81
| Facility | | $4,265.80 | $20,892.96 | $36,307.81 |