- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $2,816.00 / $8,450.00
| Facility | | $803.00 | $2,816.00 | $8,450.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,549.66 / $4,664.01 / $9,452.39
| Facility | | $2,549.66 | $4,664.01 | $9,452.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.02 / $781.02 / $806.84
| Facility | | $781.02 | $781.02 | $806.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,770.00 / $2,213.00 / $2,846.05
| Facility | | $1,770.00 | $2,213.00 | $2,846.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,558.29 / $11,500.00 / $16,394.00
| Facility | | $9,558.29 | $11,500.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.48 / $1,008.52 / $1,897.08
| Facility | | $812.48 | $1,008.52 | $1,897.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.48 / $1,019.05 / $2,041.31
| Facility | | $812.48 | $1,019.05 | $2,041.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,166.00 / $10,600.00
| Facility | | $1,634.00 | $4,166.00 | $10,600.00 |