- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.36 / $5,116.62 / $18,800.00
| Facility | | $706.36 | $5,116.62 | $18,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,968.10 / $10,260.03 / $25,560.89
| Facility | | $5,968.10 | $10,260.03 | $25,560.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,995.91 / $2,995.91 / $4,991.14
| Facility | | $2,995.91 | $2,995.91 | $4,991.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $483.81 / $930.61 / $6,620.15
| Facility | | $483.81 | $930.61 | $6,620.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.79 / $758.00 / $805.00
| Facility | | $582.79 | $758.00 | $805.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.33 / $531.03 / $1,470.05
| Facility | | $517.33 | $531.03 | $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 |