- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $2,550.00 / $7,542.00
| Facility | | $652.00 | $2,550.00 | $7,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,194.73 / $4,160.92 / $8,173.76
| Facility | | $2,194.73 | $4,160.92 | $8,173.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $401.96 / $403.05
| Facility | | $80.00 | $401.96 | $403.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.65 / $490.65 / $490.65
| Facility | | $490.65 | $490.65 | $490.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,614.76 / $11,500.00 / $16,394.00
| Facility | | $1,614.76 | $11,500.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.51 / $508.95 / $805.22
| Facility | | $395.51 | $508.95 | $805.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.51 / $512.36 / $859.66
| Facility | | $395.51 | $512.36 | $859.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,326.00 / $7,600.00
| Facility | | $1,154.00 | $3,326.00 | $7,600.00 |