- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $8,317.64 / $12,302.69
| Facility | | $602.56 | $8,317.64 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,090.30 / $7,943.28
| Facility | | $1,000.00 | $3,090.30 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $407.38 / $1,737.80
| Facility | | $371.54 | $407.38 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $660.69 / $4,168.69
| Facility | | $575.44 | $660.69 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $660.69 / $2,818.38
| Facility | | $575.44 | $660.69 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $3,388.44
| Facility | | $100.00 | $100.00 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $5,128.61 / $7,943.28
| Facility | | $933.25 | $5,128.61 | $7,943.28 |