- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $742.70 / $3,623.00 / $8,247.00
| Facility | | $742.70 | $3,623.00 | $8,247.00 |
- 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
- $812.52 / $812.52 / $812.52
| Facility | | $812.52 | $812.52 | $812.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,761.97 / $15,377.48 / $98,023.60
| Facility | | $1,761.97 | $15,377.48 | $98,023.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.30 / $3,964.00 / $8,247.00
| Facility | | $771.30 | $3,964.00 | $8,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.52 / $812.52 / $812.52
| Facility | | $812.52 | $812.52 | $812.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $697.17 / $697.17 / $710.04
| Facility | | $697.17 | $697.17 | $710.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $9,631.00
| Facility | | $2,468.00 | $4,563.00 | $9,631.00 |