- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.39 / $5,342.00 / $11,507.96
| Facility | | $732.39 | $5,342.00 | $11,507.96 |
- 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
- $639.45 / $639.45 / $639.45
| Facility | | $639.45 | $639.45 | $639.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,148.25 / $15,377.48 / $28,315.10
| Facility | | $3,148.25 | $15,377.48 | $28,315.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $804.75 / $5,342.00 / $15,000.13
| Facility | | $804.75 | $5,342.00 | $15,000.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $639.45 / $639.45 / $639.45
| Facility | | $639.45 | $639.45 | $639.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.29 / $549.71 / $549.71
| Facility | | $516.29 | $549.71 | $549.71 |
- 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 |