- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.09 / $1,072.08 / $14,464.32
| Facility | | $644.09 | $1,072.08 | $14,464.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,435.52 / $12,000.00 / $20,518.75
| Facility | | $2,435.52 | $12,000.00 | $20,518.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $6,910.09
| Facility | | $466.83 | $568.48 | $6,910.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.14 / $798.93 / $5,194.27
| Facility | | $432.14 | $798.93 | $5,194.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.50 / $858.94 / $936.66
| Facility | | $594.50 | $858.94 | $936.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $638.73 / $904.15 / $3,953.90
| Facility | | $638.73 | $904.15 | $3,953.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,761.59 / $16,595.73 / $31,745.76
| Facility | | $10,761.59 | $16,595.73 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,100.00 / $2,038.00 / $10,522.00
| Facility | | $1,100.00 | $2,038.00 | $10,522.00 |