- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $923.00 / $3,620.00 / $12,040.00
| Facility | | $923.00 | $3,620.00 | $12,040.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,494.15 / $4,324.00 / $8,258.41
| Facility | | $2,494.15 | $4,324.00 | $8,258.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.85 / $666.85 / $666.85
| Facility | | $666.85 | $666.85 | $666.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,280.46 / $2,280.46 / $2,280.46
| Facility | | $2,280.46 | $2,280.46 | $2,280.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,011.04 / $26,542.00 / $26,542.00
| Facility | | $9,011.04 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.30 / $966.16 / $1,782.50
| Facility | | $763.30 | $966.16 | $1,782.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.30 / $995.17 / $2,070.00
| Facility | | $763.30 | $995.17 | $2,070.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,693.00 / $5,231.00 / $10,476.00
| Facility | | $1,693.00 | $5,231.00 | $10,476.00 |