- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $913.25 / $4,500.00 / $20,680.40
| Facility | | $913.25 | $4,500.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,208.98 / $7,929.30 / $26,542.00
| Facility | | $1,208.98 | $7,929.30 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $918.00 / $3,311.26
| Facility | | $714.97 | $918.00 | $3,311.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.08 / $1,367.35 / $3,028.83
| Facility | | $730.08 | $1,367.35 | $3,028.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.14 / $1,264.96 / $1,317.22
| Facility | | $924.14 | $1,264.96 | $1,317.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.26 / $929.09 / $1,915.04
| Facility | | $884.26 | $929.09 | $1,915.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,324.56 / $7,956.97 / $15,220.78
| Facility | | $5,324.56 | $7,956.97 | $15,220.78 |
- 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 |