- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.20 / $1,201.76 / $17,100.00
| Facility | | $300.20 | $1,201.76 | $17,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.96 / $9,879.37 / $18,898.13
| Facility | | $767.96 | $9,879.37 | $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
- $260.51 / $682.22 / $3,140.04
| Facility | | $260.51 | $682.22 | $3,140.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.11 / $824.10 / $964.92
| Facility | | $315.11 | $824.10 | $964.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.58 / $623.33 / $1,470.05
| Facility | | $615.58 | $623.33 | $1,470.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,406.33 / $9,873.73 / $18,898.13
| Facility | | $6,406.33 | $9,873.73 | $18,898.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $2,431.00 / $11,261.00
| Facility | | $1,550.00 | $2,431.00 | $11,261.00 |