- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $5,495.41 / $9,772.37
| Facility | | $831.76 | $5,495.41 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,023.29
| Facility | | $1,023.29 | $1,023.29 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $7,244.36 / $15,488.17
| Facility | | $3,801.89 | $7,244.36 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $4,786.30 / $9,772.37
| Facility | | $831.76 | $4,786.30 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $1,230.27
| Facility | | $602.56 | $602.56 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $575.44 / $588.84
| Facility | | $549.54 | $575.44 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,981.07 / $10,000.00
| Facility | | $1,348.96 | $3,981.07 | $10,000.00 |