- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.36 / $3,066.00 / $8,451.00
| Facility | | $650.36 | $3,066.00 | $8,451.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.13 / $694.13 / $694.13
| Facility | | $694.13 | $694.13 | $694.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,131.70 / $10,131.70 / $13,084.27
| Facility | | $10,131.70 | $10,131.70 | $13,084.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,427.00
| Facility | | $832.00 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.13 / $694.13 / $694.13
| Facility | | $694.13 | $694.13 | $694.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.54 / $590.54 / $631.46
| Facility | | $590.54 | $590.54 | $631.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |