- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.76 / $3,627.00 / $7,363.20
| Facility | | $691.76 | $3,627.00 | $7,363.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.71 / $541.71 / $541.71
| Facility | | $541.71 | $541.71 | $541.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,226.52 / $6,853.46 / $8,720.29
| Facility | | $2,226.52 | $6,853.46 | $8,720.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,964.00 / $8,017.00
| Facility | | $832.00 | $3,964.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.71 / $541.71 / $541.71
| Facility | | $541.71 | $541.71 | $541.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.74 / $468.74 / $533.87
| Facility | | $468.74 | $468.74 | $533.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |