- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.29 / $2,514.00 / $7,495.00
| Facility | | $650.29 | $2,514.00 | $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
- $420.49 / $6,732.01 / $6,732.01
| Facility | | $420.49 | $6,732.01 | $6,732.01 |
- 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
- $3,899.42 / $16,394.00 / $16,394.00
| Facility | | $3,899.42 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.04 / $689.50 / $1,283.83
| Facility | | $504.04 | $689.50 | $1,283.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.04 / $693.53 / $1,341.99
| Facility | | $504.04 | $693.53 | $1,341.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,314.00 / $7,600.00
| Facility | | $1,154.00 | $3,314.00 | $7,600.00 |