- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.75 / $3,354.00 / $20,680.40
| Facility | | $763.75 | $3,354.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,598.26 / $26,542.00 / $38,538.61
| Facility | | $3,598.26 | $26,542.00 | $38,538.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $918.00 / $11,596.76
| Facility | | $714.97 | $918.00 | $11,596.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.15 / $1,094.17 / $10,169.98
| Facility | | $555.15 | $1,094.17 | $10,169.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.30 / $855.31 / $1,017.06
| Facility | | $720.30 | $855.31 | $1,017.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.50 / $2,302.86 / $5,074.92
| Facility | | $600.50 | $2,302.86 | $5,074.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,479.97 / $28,466.04 / $55,801.25
| Facility | | $12,479.97 | $28,466.04 | $55,801.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,900.00 / $4,686.00 / $19,271.00
| Facility | | $1,900.00 | $4,686.00 | $19,271.00 |