- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $893.00 / $3,682.00 / $13,401.00
| Facility | | $893.00 | $3,682.00 | $13,401.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,566.25 / $4,714.74 / $10,056.11
| Facility | | $2,566.25 | $4,714.74 | $10,056.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.11 / $419.11 / $419.11
| Facility | | $419.11 | $419.11 | $419.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,804.61 / $2,804.61 / $2,804.61
| Facility | | $2,804.61 | $2,804.61 | $2,804.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,096.10 / $16,026.00 / $16,026.00
| Facility | | $3,096.10 | $16,026.00 | $16,026.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.69 / $613.66 / $1,077.28
| Facility | | $490.69 | $613.66 | $1,077.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.69 / $620.36 / $1,229.66
| Facility | | $490.69 | $620.36 | $1,229.66 |
- 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 |