- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.00 / $2,640.00 / $7,495.00
| Facility | | $632.00 | $2,640.00 | $7,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,383.30 / $4,362.30 / $8,895.81
| Facility | | $2,383.30 | $4,362.30 | $8,895.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.85 / $2,029.49 / $2,029.49
| Facility | | $221.85 | $2,029.49 | $2,029.49 |
- 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 / $16,394.00 / $16,394.00
| Facility | | $9,011.04 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.54 / $325.70 / $630.00
| Facility | | $250.54 | $325.70 | $630.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.54 / $334.88 / $683.74
| Facility | | $250.54 | $334.88 | $683.74 |
- 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 |