- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $929.54 / $3,810.00 / $18,711.00
| Facility | | $929.54 | $3,810.00 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,298.40 / $16,223.75 / $21,602.23
| Facility | | $3,298.40 | $16,223.75 | $21,602.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $6,775.01
| Facility | | $625.25 | $761.81 | $6,775.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.75 / $1,424.50 / $6,197.13
| Facility | | $750.75 | $1,424.50 | $6,197.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $952.07 / $1,301.69 / $1,357.42
| Facility | | $952.07 | $1,301.69 | $1,357.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $916.87 / $1,460.91 / $3,875.03
| Facility | | $916.87 | $1,460.91 | $3,875.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,603.20 / $16,351.48 / $31,278.54
| Facility | | $10,603.20 | $16,351.48 | $31,278.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $2,759.00 / $11,941.00
| Facility | | $1,300.00 | $2,759.00 | $11,941.00 |