- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.96 / $2,791.00 / $8,451.00
| Facility | | $512.96 | $2,791.00 | $8,451.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,150.00 / $7,463.00 / $11,091.00
| Facility | | $4,150.00 | $7,463.00 | $11,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.19 / $706.19 / $706.19
| Facility | | $706.19 | $706.19 | $706.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,149.60 / $8,075.01 / $11,938.27
| Facility | | $3,149.60 | $8,075.01 | $11,938.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.96 / $3,838.00 / $9,534.00
| Facility | | $512.96 | $3,838.00 | $9,534.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.19 / $706.19 / $706.19
| Facility | | $706.19 | $706.19 | $706.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.73 / $399.16 / $535.11
| Facility | | $343.73 | $399.16 | $535.11 |
- 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 |