- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.64 / $5,128.00 / $18,711.00
| Facility | | $791.64 | $5,128.00 | $18,711.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,795.87 / $5,471.61 / $12,100.72
| Facility | | $1,795.87 | $5,471.61 | $12,100.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $2,190.81
| Facility | | $625.25 | $761.81 | $2,190.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.91 / $896.11 / $1,921.26
| Facility | | $438.91 | $896.11 | $1,921.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.04 / $797.97 / $871.67
| Facility | | $577.04 | $797.97 | $871.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $561.27 / $594.55 / $1,795.87
| Facility | | $561.27 | $594.55 | $1,795.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,913.81 / $5,468.48 / $10,466.57
| Facility | | $3,913.81 | $5,468.48 | $10,466.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $2,408.00 / $10,522.00
| Facility | | $1,547.00 | $2,408.00 | $10,522.00 |