- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $3,504.00 / $11,232.00
| Facility | | $657.00 | $3,504.00 | $11,232.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,514.53 / $4,574.62 / $8,937.17
| Facility | | $2,514.53 | $4,574.62 | $8,937.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.48 / $413.48 / $413.48
| Facility | | $413.48 | $413.48 | $413.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,207.78 / $2,207.78 / $2,207.78
| Facility | | $2,207.78 | $2,207.78 | $2,207.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,206.00 / $26,542.00 / $26,542.00
| Facility | | $2,206.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.11 / $582.61 / $1,079.08
| Facility | | $413.11 | $582.61 | $1,079.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.11 / $583.86 / $1,200.44
| Facility | | $413.11 | $583.86 | $1,200.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,314.00 / $7,600.00
| Facility | | $1,154.00 | $3,314.00 | $7,600.00 |