- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $913.94 / $3,925.18 / $20,680.40
| Facility | | $913.94 | $3,925.18 | $20,680.40 |
- 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
- $851.76 / $1,556.28 / $5,967.13
| Facility | | $851.76 | $1,556.28 | $5,967.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $975.10 / $1,330.62 / $1,382.88
| Facility | | $975.10 | $1,330.62 | $1,382.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $920.04 / $943.25 / $2,173.03
| Facility | | $920.04 | $943.25 | $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 |