- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $3,682.00 / $12,281.00
| Facility | | $921.00 | $3,682.00 | $12,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.89 / $2,645.07 / $5,144.45
| Facility | | $1,480.89 | $2,645.07 | $5,144.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.62 / $816.62 / $836.46
| Facility | | $816.62 | $816.62 | $836.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,075.60 / $26,542.00 / $26,542.00
| Facility | | $6,075.60 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $799.22 / $996.82 / $1,378.89
| Facility | | $799.22 | $996.82 | $1,378.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.30 / $1,001.74 / $1,446.90
| Facility | | $803.30 | $1,001.74 | $1,446.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $2,064.00 / $4,554.00
| Facility | | $597.00 | $2,064.00 | $4,554.00 |