- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.59 / $11,837.00 / $32,170.04
| Facility | | $851.59 | $11,837.00 | $32,170.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,886.41 / $16,351.48 / $31,278.54
| Facility | | $9,886.41 | $16,351.48 | $31,278.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,066.66 / $4,066.66 / $6,775.01
| Facility | | $4,066.66 | $4,066.66 | $6,775.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.90 / $960.38 / $12,766.31
| Facility | | $571.90 | $960.38 | $12,766.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.14 / $850.57 / $923.26
| Facility | | $630.14 | $850.57 | $923.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.10 / $629.75 / $2,429.53
| Facility | | $611.10 | $629.75 | $2,429.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,684.88 / $16,342.14 / $31,278.54
| Facility | | $10,684.88 | $16,342.14 | $31,278.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $4,686.00 / $20,708.00
| Facility | | $3,028.00 | $4,686.00 | $20,708.00 |