- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $903.14 / $4,392.00 / $10,296.00
| Facility | | $903.14 | $4,392.00 | $10,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.00 / $7,264.00 / $12,274.00
| Facility | | $4,100.00 | $7,264.00 | $12,274.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,059.45 / $1,059.45 / $37,499.62
| Facility | | $1,059.45 | $1,059.45 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $855.04 / $855.04 / $7,227.90
| Facility | | $855.04 | $855.04 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $797.40 / $1,999.53
| Facility | | $319.00 | $797.40 | $1,999.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $855.04 / $7,227.90
| Facility | | $555.00 | $855.04 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,749.00 / $4,194.00 / $9,300.00
| Facility | | $1,749.00 | $4,194.00 | $9,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $802.41 / $802.41 / $1,638.38
| Facility | | $802.41 | $802.41 | $1,638.38 |