- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.36 / $2,266.00 / $7,175.00
| Facility | | $491.36 | $2,266.00 | $7,175.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $719.22 / $719.22 / $719.22
| Facility | | $719.22 | $719.22 | $719.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,997.56 / $1,997.56 / $1,997.56
| Facility | | $1,997.56 | $1,997.56 | $1,997.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,326.00 / $8,017.00
| Facility | | $617.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $719.22 / $719.22 / $719.22
| Facility | | $719.22 | $719.22 | $719.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.35 / $418.27 / $456.72
| Facility | | $414.35 | $418.27 | $456.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |