- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.04 / $2,070.00 / $7,197.00
| Facility | | $470.04 | $2,070.00 | $7,197.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $434.02 / $434.02 / $434.02
| Facility | | $434.02 | $434.02 | $434.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.45 / $5,979.45 / $5,979.45
| Facility | | $5,979.45 | $5,979.45 | $5,979.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,266.00 / $8,017.00
| Facility | | $641.00 | $2,266.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $434.02 / $434.02 / $434.02
| Facility | | $434.02 | $434.02 | $434.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $249.12 / $293.43 / $427.12
| Facility | | $249.12 | $293.43 | $427.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,781.00 / $3,947.92 / $9,211.81
| Facility | | $1,781.00 | $3,947.92 | $9,211.81 |