- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.55 / $3,014.02 / $8,113.00
| Facility | | $825.55 | $3,014.02 | $8,113.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $800.00 / $3,204.37
| Facility | | $500.00 | $800.00 | $3,204.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,287.55 / $6,287.55 / $6,287.55
| Facility | | $6,287.55 | $6,287.55 | $6,287.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.55 / $4,761.00 / $8,247.00
| Facility | | $825.55 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,757.40 / $2,757.40 / $2,757.40
| Facility | | $2,757.40 | $2,757.40 | $2,757.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $800.00 / $3,204.37
| Facility | | $500.00 | $800.00 | $3,204.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,515.00 / $2,759.39 / $2,759.39
| Facility | | $2,515.00 | $2,759.39 | $2,759.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.00 / $2,020.00 / $6,322.00
| Facility | | $388.00 | $2,020.00 | $6,322.00 |