- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.86 / $3,553.20 / $17,930.00
| Facility | | $259.86 | $3,553.20 | $17,930.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $986.58 / $5,068.58 / $16,394.00
| Facility | | $986.58 | $5,068.58 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $2,046.84
| Facility | | $625.25 | $761.81 | $2,046.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.61 / $333.01 / $2,097.69
| Facility | | $172.61 | $333.01 | $2,097.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.77 / $276.43 / $299.49
| Facility | | $231.77 | $276.43 | $299.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.81 / $416.80 / $1,167.02
| Facility | | $189.81 | $416.80 | $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 |