- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $770.27 / $3,174.00 / $10,234.00
| Facility | | $770.27 | $3,174.00 | $10,234.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.98 / $3,680.36 / $7,337.28
| Facility | | $2,093.98 | $3,680.36 | $7,337.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.69 / $672.69 / $686.13
| Facility | | $672.69 | $672.69 | $686.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,512.62 / $2,006.70 / $2,530.00
| Facility | | $1,512.62 | $2,006.70 | $2,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,929.30 / $11,500.00 / $26,542.00
| Facility | | $7,929.30 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.20 / $861.76 / $1,569.94
| Facility | | $710.20 | $861.76 | $1,569.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.36 / $879.74 / $1,689.21
| Facility | | $712.36 | $879.74 | $1,689.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,200.00 / $10,600.00
| Facility | | $1,634.00 | $4,200.00 | $10,600.00 |