- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $481.62 / $2,747.39 / $18,711.00
| Facility | | $481.62 | $2,747.39 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,470.05 / $9,286.14 / $18,898.13
| Facility | | $1,470.05 | $9,286.14 | $18,898.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,353.44 / $2,353.44 / $3,920.80
| Facility | | $2,353.44 | $2,353.44 | $3,920.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.92 / $1,647.73 / $3,438.40
| Facility | | $422.92 | $1,647.73 | $3,438.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.60 / $2,061.59 / $2,339.19
| Facility | | $522.60 | $2,061.59 | $2,339.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,470.05 / $1,499.87 / $1,558.32
| Facility | | $1,470.05 | $1,499.87 | $1,558.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,529.68 / $9,873.73 / $18,898.13
| Facility | | $6,529.68 | $9,873.73 | $18,898.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,297.00 / $12,835.00
| Facility | | $2,155.00 | $3,297.00 | $12,835.00 |