- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $788.00 / $3,188.00 / $10,836.00
| Facility | | $788.00 | $3,188.00 | $10,836.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,785.56 / $9,092.56 / $18,252.08
| Facility | | $4,785.56 | $9,092.56 | $18,252.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.51 / $5,281.24 / $5,281.24
| Facility | | $567.51 | $5,281.24 | $5,281.24 |
- 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
- $3,435.72 / $19,913.50 / $26,542.00
| Facility | | $3,435.72 | $19,913.50 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.29 / $770.38 / $1,173.51
| Facility | | $592.29 | $770.38 | $1,173.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.89 / $770.38 / $1,238.10
| Facility | | $595.89 | $770.38 | $1,238.10 |
- 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 |