- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $981.09 / $3,682.00 / $12,281.00
| Facility | | $981.09 | $3,682.00 | $12,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,803.99 / $4,909.47 / $9,381.18
| Facility | | $2,803.99 | $4,909.47 | $9,381.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.54 / $948.96 / $948.96
| Facility | | $823.54 | $948.96 | $948.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,953.70 / $1,953.70 / $2,017.56
| Facility | | $1,953.70 | $1,953.70 | $2,017.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,001.70 / $26,542.00 / $26,542.00
| Facility | | $9,001.70 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $829.20 / $1,068.76 / $1,549.26
| Facility | | $829.20 | $1,068.76 | $1,549.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.94 / $1,101.78 / $1,814.36
| Facility | | $850.94 | $1,101.78 | $1,814.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,200.00 / $10,600.00
| Facility | | $1,634.00 | $4,200.00 | $10,600.00 |