- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.70 / $2,464.17 / $8,017.00
| Facility | | $526.70 | $2,464.17 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,404.00 / $4,354.00 / $8,639.91
| Facility | | $2,404.00 | $4,354.00 | $8,639.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.12 / $585.12 / $585.12
| Facility | | $585.12 | $585.12 | $585.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,720.68 / $5,464.22 / $18,064.25
| Facility | | $1,720.68 | $5,464.22 | $18,064.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.70 / $1,901.00 / $8,017.00
| Facility | | $526.70 | $1,901.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.12 / $585.12 / $585.12
| Facility | | $585.12 | $585.12 | $585.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.88 / $337.32 / $547.13
| Facility | | $336.88 | $337.32 | $547.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $1,219.00 / $3,742.00
| Facility | | $471.00 | $1,219.00 | $3,742.00 |