- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $3,142.00 / $8,017.00
| Facility | | $882.00 | $3,142.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.89 / $852.89 / $852.89
| Facility | | $852.89 | $852.89 | $852.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,679.89 / $15,089.40 / $16,653.91
| Facility | | $10,679.89 | $15,089.40 | $16,653.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,839.00 / $8,017.00
| Facility | | $1,013.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.89 / $852.89 / $852.89
| Facility | | $852.89 | $852.89 | $852.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.81 / $732.81 / $882.11
| Facility | | $732.81 | $732.81 | $882.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |