- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.00 / $3,445.00 / $9,458.00
| Facility | | $651.00 | $3,445.00 | $9,458.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,436.33 / $4,325.17 / $8,431.35
| Facility | | $2,436.33 | $4,325.17 | $8,431.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.38 / $2,359.02 / $2,359.02
| Facility | | $388.38 | $2,359.02 | $2,359.02 |
- 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
- $1,948.80 / $11,500.00 / $26,542.00
| Facility | | $1,948.80 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.72 / $568.22 / $899.26
| Facility | | $415.72 | $568.22 | $899.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.72 / $573.47 / $922.78
| Facility | | $415.72 | $573.47 | $922.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |