- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.65 / $6,259.76 / $17,100.00
| Facility | | $356.65 | $6,259.76 | $17,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,518.34 / $5,772.11 / $14,934.15
| Facility | | $3,518.34 | $5,772.11 | $14,934.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,364.71 / $1,364.71 / $2,273.59
| Facility | | $1,364.71 | $1,364.71 | $2,273.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.50 / $439.53 / $5,967.13
| Facility | | $241.50 | $439.53 | $5,967.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.12 / $371.18 / $393.29
| Facility | | $288.12 | $371.18 | $393.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.30 / $268.26 / $839.66
| Facility | | $257.30 | $268.26 | $839.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,211.81 / $5,768.81 / $11,041.39
| Facility | | $4,211.81 | $5,768.81 | $11,041.39 |
- 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 |