- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $744.71 / $4,723.00 / $11,627.00
| Facility | | $744.71 | $4,723.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,785.00 / $8,239.18 / $15,310.83
| Facility | | $2,785.00 | $8,239.18 | $15,310.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $713.28 / $855.94 / $1,059.41
| Facility | | $713.28 | $855.94 | $1,059.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $852.18 / $21,571.00
| Facility | | $425.00 | $852.18 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $600.00 / $1,200.00
| Facility | | $425.00 | $600.00 | $1,200.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.00 / $2,883.00 / $6,111.00
| Facility | | $650.00 | $2,883.00 | $6,111.00 |