- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.75 / $4,629.00 / $11,080.00
| Facility | | $890.75 | $4,629.00 | $11,080.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,248.00 / $5,196.00 / $11,909.00
| Facility | | $3,248.00 | $5,196.00 | $11,909.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,008.10 / $2,390.00 / $10,957.50
| Facility | | $1,008.10 | $2,390.00 | $10,957.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $817.25 / $817.25 / $817.25
| Facility | | $817.25 | $817.25 | $817.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,072.00 / $1,921.91
| Facility | | $332.00 | $1,072.00 | $1,921.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.07 / $677.07 / $677.07
| Facility | | $677.07 | $677.07 | $677.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $597.00 / $817.25
| Facility | | $555.00 | $597.00 | $817.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,264.00 / $5,248.00 / $11,200.00
| Facility | | $2,264.00 | $5,248.00 | $11,200.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $861.97 / $861.97 / $3,250.54
| Facility | | $861.97 | $861.97 | $3,250.54 |