- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.52 / $2,747.00 / $8,240.00
| Facility | | $487.52 | $2,747.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.08 / $574.08 / $574.08
| Facility | | $574.08 | $574.08 | $574.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,827.45 / $14,045.14 / $33,446.79
| Facility | | $8,827.45 | $14,045.14 | $33,446.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.16 / $3,830.00 / $8,404.00
| Facility | | $527.16 | $3,830.00 | $8,404.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.08 / $574.08 / $574.08
| Facility | | $574.08 | $574.08 | $574.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.80 / $416.21 / $488.95
| Facility | | $325.80 | $416.21 | $488.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |