- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.00 / $2,128.00 / $6,762.00
| Facility | | $474.00 | $2,128.00 | $6,762.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,173.72 / $6,347.43 / $12,610.23
| Facility | | $3,173.72 | $6,347.43 | $12,610.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.51 / $341.51 / $341.51
| Facility | | $341.51 | $341.51 | $341.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,619.61 / $3,619.61 / $3,619.61
| Facility | | $3,619.61 | $3,619.61 | $3,619.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,546.56 / $12,000.00 / $12,000.00
| Facility | | $3,546.56 | $12,000.00 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.27 / $574.12 / $1,074.02
| Facility | | $413.27 | $574.12 | $1,074.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.27 / $588.54 / $1,175.81
| Facility | | $413.27 | $588.54 | $1,175.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,314.00 / $7,600.00
| Facility | | $1,154.00 | $3,314.00 | $7,600.00 |