- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $972.62 / $7,377.01 / $10,034.00
| Facility | | $972.62 | $7,377.01 | $10,034.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,540.11 / $3,894.12 / $6,608.20
| Facility | | $3,540.11 | $3,894.12 | $6,608.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.00 / $2,938.91 / $5,544.25
| Facility | | $515.00 | $2,938.91 | $5,544.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $718.02 / $1,391.86 / $6,184.49
| Facility | | $718.02 | $1,391.86 | $6,184.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,717.00 / $2,500.00 / $18,665.00
| Facility | | $1,717.00 | $2,500.00 | $18,665.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $6,611.84 / $6,611.84
| Facility | | $55.00 | $6,611.84 | $6,611.84 |