- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $805.49 / $3,158.00 / $8,442.00
| Facility | | $805.49 | $3,158.00 | $8,442.00 |
- 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
- $882.08 / $1,716.00 / $6,213.00
| Facility | | $882.08 | $1,716.00 | $6,213.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,065.33 / $1,065.33 / $4,612.43
| Facility | | $1,065.33 | $1,065.33 | $4,612.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $705.00 / $1,647.00
| Facility | | $319.00 | $705.00 | $1,647.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,844.46 / $3,844.46 / $3,844.46
| Facility | | $3,844.46 | $3,844.46 | $3,844.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $1,065.33 / $4,612.43
| Facility | | $555.00 | $1,065.33 | $4,612.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,031.00 / $4,840.00 / $9,202.00
| Facility | | $2,031.00 | $4,840.00 | $9,202.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.19 / $760.19 / $2,589.14
| Facility | | $760.19 | $760.19 | $2,589.14 |