- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $907.16 / $3,596.00 / $12,281.00
| Facility | | $907.16 | $3,596.00 | $12,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,460.41 / $4,325.17 / $8,431.35
| Facility | | $2,460.41 | $4,325.17 | $8,431.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $694.83 / $694.83
| Facility | | $80.00 | $694.83 | $694.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $841.83 / $841.83 / $841.83
| Facility | | $841.83 | $841.83 | $841.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,738.24 / $11,500.00 / $26,542.00
| Facility | | $2,738.24 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $696.29 / $930.57 / $1,454.60
| Facility | | $696.29 | $930.57 | $1,454.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $697.46 / $934.76 / $1,500.91
| Facility | | $697.46 | $934.76 | $1,500.91 |
- 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 |