- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.79 / $2,117.71 / $14,482.00
| Facility | | $969.79 | $2,117.71 | $14,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,084.00 / $12,066.00 / $19,370.00
| Facility | | $7,084.00 | $12,066.00 | $19,370.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,653.80 / $3,101.17 / $5,002.08
| Facility | | $2,653.80 | $3,101.17 | $5,002.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.79 / $1,388.31 / $6,085.47
| Facility | | $969.79 | $1,388.31 | $6,085.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,035.33 / $2,803.00 / $7,700.00
| Facility | | $1,035.33 | $2,803.00 | $7,700.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.79 / $1,621.97 / $6,085.47
| Facility | | $969.79 | $1,621.97 | $6,085.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,070.90 / $3,186.00 / $4,394.38
| Professional | | $2,070.90 | $3,186.00 | $4,394.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,554.00 / $8,554.00 / $8,554.00
| Facility | | $8,554.00 | $8,554.00 | $8,554.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,429.00 / $6,163.00 / $19,003.00
| Facility | | $2,429.00 | $6,163.00 | $19,003.00 |