- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.25 / $5,116.62 / $18,800.00
| Facility | | $554.25 | $5,116.62 | $18,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,968.10 / $9,879.37 / $25,560.89
| Facility | | $5,968.10 | $9,879.37 | $25,560.89 |
- 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
- $378.98 / $723.54 / $6,620.15
| Facility | | $378.98 | $723.54 | $6,620.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.23 / $594.96 / $629.41
| Facility | | $454.23 | $594.96 | $629.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.44 / $416.78 / $1,470.05
| Facility | | $405.44 | $416.78 | $1,470.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,406.33 / $9,879.37 / $18,898.13
| Facility | | $6,406.33 | $9,879.37 | $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 |