- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $3,174.00 / $10,836.00
| Facility | | $921.00 | $3,174.00 | $10,836.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,122.95 / $7,372.81 / $14,745.61
| Facility | | $4,122.95 | $7,372.81 | $14,745.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $967.44 / $3,633.09 / $3,633.09
| Facility | | $967.44 | $3,633.09 | $3,633.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.43 / $1,902.43 / $1,902.43
| Facility | | $1,902.43 | $1,902.43 | $1,902.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,714.38 / $11,500.00 / $26,542.00
| Facility | | $7,714.38 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.06 / $1,462.29 / $2,324.69
| Facility | | $1,123.06 | $1,462.29 | $2,324.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.61 / $1,472.50 / $2,448.59
| Facility | | $1,123.61 | $1,472.50 | $2,448.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $13,134.00
| Facility | | $2,093.00 | $6,000.00 | $13,134.00 |