- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.25 / $5,128.00 / $20,680.40
| Facility | | $761.25 | $5,128.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,613.81 / $4,554.63 / $11,500.00
| Facility | | $1,613.81 | $4,554.63 | $11,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $1,985.59
| Facility | | $714.97 | $870.49 | $1,985.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.16 / $847.17 / $1,741.30
| Facility | | $407.16 | $847.17 | $1,741.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.79 / $778.60 / $923.93
| Facility | | $537.79 | $778.60 | $923.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.44 / $621.05 / $1,613.81
| Facility | | $537.44 | $621.05 | $1,613.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,323.45 / $4,552.03 / $8,712.50
| Facility | | $3,323.45 | $4,552.03 | $8,712.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.00 / $1,436.00 / $6,857.00
| Facility | | $702.00 | $1,436.00 | $6,857.00 |