- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.05 / $2,291.00 / $18,711.00
| Facility | | $815.05 | $2,291.00 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,545.36 / $11,102.00 / $13,431.71
| Facility | | $2,545.36 | $11,102.00 | $13,431.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $4,636.17
| Facility | | $466.83 | $568.48 | $4,636.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.25 / $1,259.48 / $4,240.71
| Facility | | $659.25 | $1,259.48 | $4,240.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $836.43 / $1,145.03 / $1,204.66
| Facility | | $836.43 | $1,145.03 | $1,204.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $805.43 / $1,195.26 / $2,776.76
| Facility | | $805.43 | $1,195.26 | $2,776.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,832.97 / $10,166.93 / $19,448.18
| Facility | | $6,832.97 | $10,166.93 | $19,448.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $2,759.00 / $11,941.00
| Facility | | $1,300.00 | $2,759.00 | $11,941.00 |