- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $542.70 / $3,060.00 / $10,234.00
| Facility | | $542.70 | $3,060.00 | $10,234.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,471.03 / $7,081.77 / $14,309.06
| Facility | | $3,471.03 | $7,081.77 | $14,309.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.23 / $305.23 / $434.56
| Facility | | $305.23 | $305.23 | $434.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,024.00 / $3,741.00 / $4,187.68
| Facility | | $2,024.00 | $3,741.00 | $4,187.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,394.60 / $11,500.00 / $26,542.00
| Facility | | $2,394.60 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $472.46 / $804.46
| Facility | | $346.74 | $472.46 | $804.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.09 / $478.64 / $952.46
| Facility | | $347.09 | $478.64 | $952.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,190.00 / $3,239.00 / $7,600.00
| Facility | | $1,190.00 | $3,239.00 | $7,600.00 |