- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.00 / $2,286.13 / $17,930.00
| Facility | | $801.00 | $2,286.13 | $17,930.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.34 / $6,622.22 / $14,645.34
| Facility | | $1,230.34 | $6,622.22 | $14,645.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $734.00 / $734.00 / $2,430.19
| Facility | | $734.00 | $734.00 | $2,430.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.79 / $1,186.72 / $2,305.46
| Facility | | $611.79 | $1,186.72 | $2,305.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.59 / $1,632.15 / $1,800.29
| Facility | | $973.59 | $1,632.15 | $1,800.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $925.25 / $1,230.34 / $1,230.34
| Facility | | $925.25 | $1,230.34 | $1,230.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,294.21 / $6,618.43 / $12,667.56
| Facility | | $4,294.21 | $6,618.43 | $12,667.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $1,862.00 / $10,522.00
| Facility | | $1,224.00 | $1,862.00 | $10,522.00 |