- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.92 / $2,747.00 / $8,113.00
| Facility | | $545.92 | $2,747.00 | $8,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.63 / $554.63 / $554.63
| Facility | | $554.63 | $554.63 | $554.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,060.35 / $15,773.46 / $24,092.03
| Facility | | $2,060.35 | $15,773.46 | $24,092.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.73 / $2,675.00 / $8,427.00
| Facility | | $546.73 | $2,675.00 | $8,427.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.63 / $554.63 / $554.63
| Facility | | $554.63 | $554.63 | $554.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.93 / $474.93 / $612.63
| Facility | | $474.93 | $474.93 | $612.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |