- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $756.75 / $2,514.00 / $7,495.00
| Facility | | $756.75 | $2,514.00 | $7,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,433.61 / $4,297.80 / $8,431.35
| Facility | | $2,433.61 | $4,297.80 | $8,431.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.75 / $2,267.04 / $2,267.04
| Facility | | $749.75 | $2,267.04 | $2,267.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $944.72 / $944.72 / $944.72
| Facility | | $944.72 | $944.72 | $944.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,869.30 / $11,500.00 / $16,394.00
| Facility | | $3,869.30 | $11,500.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.96 / $1,092.06 / $1,708.00
| Facility | | $810.96 | $1,092.06 | $1,708.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.96 / $1,095.97 / $1,782.36
| Facility | | $810.96 | $1,095.97 | $1,782.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,166.00 / $10,600.00
| Facility | | $1,634.00 | $4,166.00 | $10,600.00 |