- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $3,596.00 / $12,281.00
| Facility | | $882.00 | $3,596.00 | $12,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,518.44 / $4,325.17 / $8,431.35
| Facility | | $2,518.44 | $4,325.17 | $8,431.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.09 / $2,527.63 / $2,527.63
| Facility | | $402.09 | $2,527.63 | $2,527.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.07 / $501.07 / $501.07
| Facility | | $501.07 | $501.07 | $501.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,651.56 / $11,500.00 / $26,542.00
| Facility | | $1,651.56 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.93 / $564.11 / $867.66
| Facility | | $420.93 | $564.11 | $867.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.92 / $564.65 / $895.27
| Facility | | $422.92 | $564.65 | $895.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |