- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.48 / $3,060.00 / $10,546.00
| Facility | | $320.48 | $3,060.00 | $10,546.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,493.64 / $4,663.00 / $8,872.32
| Facility | | $2,493.64 | $4,663.00 | $8,872.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.70 / $205.70 / $359.25
| Facility | | $205.70 | $205.70 | $359.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,105.08 / $26,542.00 / $26,542.00
| Facility | | $1,105.08 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.70 / $310.49 / $488.09
| Facility | | $197.70 | $310.49 | $488.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.70 / $310.49 / $490.95
| Facility | | $197.70 | $310.49 | $490.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |