- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.14 / $6,470.00 / $18,800.00
| Facility | | $740.14 | $6,470.00 | $18,800.00 |
- 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
- $714.97 / $870.49 / $2,190.81
| Facility | | $714.97 | $870.49 | $2,190.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.69 / $851.08 / $1,921.26
| Facility | | $412.69 | $851.08 | $1,921.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.22 / $749.06 / $824.77
| Facility | | $540.22 | $749.06 | $824.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.20 / $562.57 / $1,795.87
| Facility | | $528.20 | $562.57 | $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 |