- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.44 / $3,066.00 / $7,882.67
| Facility | | $706.44 | $3,066.00 | $7,882.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,150.00 / $7,463.00 / $11,091.00
| Facility | | $4,150.00 | $7,463.00 | $11,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $713.47 / $713.47 / $713.47
| Facility | | $713.47 | $713.47 | $713.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,302.70 / $8,016.28 / $15,291.45
| Facility | | $5,302.70 | $8,016.28 | $15,291.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $3,494.00 / $8,017.00
| Facility | | $657.00 | $3,494.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $713.47 / $713.47 / $713.47
| Facility | | $713.47 | $713.47 | $713.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.12 / $607.12 / $655.99
| Facility | | $607.12 | $607.12 | $655.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $4,476.00 / $10,443.12
| Facility | | $2,332.00 | $4,476.00 | $10,443.12 |