- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.00 / $2,931.00 / $10,893.00
| Facility | | $714.00 | $2,931.00 | $10,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,182.89 / $4,243.05 / $8,173.76
| Facility | | $2,182.89 | $4,243.05 | $8,173.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.26 / $3,826.89 / $3,826.89
| Facility | | $477.26 | $3,826.89 | $3,826.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $895.23 / $895.23 / $895.23
| Facility | | $895.23 | $895.23 | $895.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.44 / $11,500.00 / $26,542.00
| Facility | | $2,637.44 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.85 / $762.35 / $1,233.15
| Facility | | $550.85 | $762.35 | $1,233.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.54 / $764.97 / $1,278.77
| Facility | | $552.54 | $764.97 | $1,278.77 |
- 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 |