- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $2,673.00 / $7,495.00
| Facility | | $652.00 | $2,673.00 | $7,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,095.42 / $3,990.00 / $7,696.71
| Facility | | $2,095.42 | $3,990.00 | $7,696.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.51 / $2,565.59 / $2,565.59
| Facility | | $384.51 | $2,565.59 | $2,565.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,001.65 / $2,001.65 / $2,001.65
| Facility | | $2,001.65 | $2,001.65 | $2,001.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,909.30 / $16,394.00 / $16,394.00
| Facility | | $7,909.30 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.38 / $556.16 / $968.03
| Facility | | $419.38 | $556.16 | $968.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.38 / $564.76 / $1,070.54
| Facility | | $419.38 | $564.76 | $1,070.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,293.00 / $7,600.00
| Facility | | $1,154.00 | $3,293.00 | $7,600.00 |