- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.55 / $1,210.03 / $17,100.00
| Facility | | $679.55 | $1,210.03 | $17,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,587.44 / $15,555.67 / $21,924.91
| Facility | | $2,587.44 | $15,555.67 | $21,924.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $6,910.09
| Facility | | $625.25 | $761.81 | $6,910.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $434.58 / $818.38 / $5,194.27
| Facility | | $434.58 | $818.38 | $5,194.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.54 / $873.01 / $959.44
| Facility | | $602.54 | $873.01 | $959.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $639.64 / $1,994.21 / $3,953.90
| Facility | | $639.64 | $1,994.21 | $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 |