- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.87 / $5,128.00 / $20,680.40
| Facility | | $418.87 | $5,128.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,033.28 / $11,788.08 / $26,542.00
| Facility | | $3,033.28 | $11,788.08 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $918.00 / $5,639.89
| Facility | | $714.97 | $918.00 | $5,639.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.58 / $598.74 / $4,946.00
| Facility | | $288.58 | $598.74 | $4,946.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.01 / $446.25 / $547.58
| Facility | | $346.01 | $446.25 | $547.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.85 / $1,107.43 / $3,033.28
| Facility | | $309.85 | $1,107.43 | $3,033.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,037.75 / $10,846.90 / $20,760.75
| Facility | | $7,037.75 | $10,846.90 | $20,760.75 |
- 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 |