- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $4,073.80 / $10,964.78
| Facility | | $977.24 | $4,073.80 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,000.00
| Facility | | $2,630.27 | $4,786.30 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $2,398.83 / $10,964.78
| Facility | | $977.24 | $2,398.83 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,412.54 / $50,118.72
| Facility | | $1,174.90 | $1,412.54 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $794.33 / $2,290.87
| Facility | | $645.65 | $794.33 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $50,118.72 / $75,857.76
| Facility | | $676.08 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $4,265.80 / $9,549.93
| Facility | | $1,905.46 | $4,265.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $954.99 / $2,041.74
| Facility | | $575.44 | $954.99 | $2,041.74 |