- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.00 / $4,264.00 / $8,017.00
| Facility | | $810.00 | $4,264.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.71 / $452.71 / $452.71
| Facility | | $452.71 | $452.71 | $452.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,057.71 / $5,017.02 / $5,815.59
| Facility | | $3,057.71 | $5,017.02 | $5,815.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.00 / $4,534.00 / $8,240.00
| Facility | | $976.00 | $4,534.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.71 / $452.71 / $452.71
| Facility | | $452.71 | $452.71 | $452.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.09 / $385.09 / $439.99
| Facility | | $385.09 | $385.09 | $439.99 |
- 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 |