- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $686.26 / $3,184.00 / $10,234.00
| Facility | | $686.26 | $3,184.00 | $10,234.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,492.73 / $4,406.34 / $8,313.84
| Facility | | $2,492.73 | $4,406.34 | $8,313.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.04 / $415.04 / $415.04
| Facility | | $415.04 | $415.04 | $415.04 |
- 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
- $455.39 / $576.75 / $1,048.26
| Facility | | $455.39 | $576.75 | $1,048.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.39 / $593.15 / $1,292.58
| Facility | | $455.39 | $593.15 | $1,292.58 |
- 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 |