- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $799.11 / $5,116.62 / $18,800.00
| Facility | | $799.11 | $5,116.62 | $18,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,562.96 / $14,663.54 / $28,049.69
| Facility | | $8,562.96 | $14,663.54 | $28,049.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,585.08 / $3,585.08 / $5,972.71
| Facility | | $3,585.08 | $3,585.08 | $5,972.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.32 / $1,050.54 / $6,620.15
| Facility | | $548.32 | $1,050.54 | $6,620.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $649.23 / $857.06 / $923.00
| Facility | | $649.23 | $857.06 | $923.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.28 / $600.50 / $2,173.03
| Facility | | $585.28 | $600.50 | $2,173.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,508.65 / $14,655.16 / $28,049.69
| Facility | | $9,508.65 | $14,655.16 | $28,049.69 |
- 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 |