- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.47 / $6,105.00 / $14,960.00
| Facility | | $306.47 | $6,105.00 | $14,960.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,076.26 / $5,068.58 / $26,542.00
| Facility | | $1,076.26 | $5,068.58 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $918.00 / $2,046.84
| Facility | | $714.97 | $918.00 | $2,046.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.04 / $582.89 / $2,097.69
| Facility | | $278.04 | $582.89 | $2,097.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.75 / $434.71 / $530.40
| Facility | | $365.75 | $434.71 | $530.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.52 / $608.39 / $1,167.02
| Facility | | $298.52 | $608.39 | $1,167.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.71 / $5,392.38 / $10,315.01
| Facility | | $3,496.71 | $5,392.38 | $10,315.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $6,576.25 / $9,713.75
| Facility | | $1,120.00 | $6,576.25 | $9,713.75 |