- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $469.21 / $7,489.85 / $18,800.00
| Facility | | $469.21 | $7,489.85 | $18,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,089.03 / $9,044.98 / $22,922.83
| Facility | | $5,089.03 | $9,044.98 | $22,922.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,380.38 / $2,380.38 / $3,965.68
| Facility | | $2,380.38 | $2,380.38 | $3,965.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.16 / $544.86 / $5,198.37
| Facility | | $306.16 | $544.86 | $5,198.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.71 / $464.31 / $513.22
| Facility | | $342.71 | $464.31 | $513.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.11 / $350.06 / $1,367.95
| Facility | | $341.11 | $350.06 | $1,367.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,745.15 / $8,854.69 / $16,947.71
| Facility | | $5,745.15 | $8,854.69 | $16,947.71 |
- 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 |