- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $4,293.51 / $13,401.00
| Facility | | $921.00 | $4,293.51 | $13,401.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,057.44 / $12,619.67 / $24,650.41
| Facility | | $6,057.44 | $12,619.67 | $24,650.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $10,144.62 / $17,596.66
| Facility | | $2,600.00 | $10,144.62 | $17,596.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.41 / $10,598.39 / $10,598.39
| Facility | | $393.41 | $10,598.39 | $10,598.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,042.75 / $10,042.75 / $10,042.75
| Facility | | $10,042.75 | $10,042.75 | $10,042.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $6,489.18
| Facility | | $55.00 | $55.00 | $6,489.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.38 / $2,922.29 / $7,218.18
| Facility | | $467.38 | $2,922.29 | $7,218.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.38 / $3,143.09 / $7,860.14
| Facility | | $467.38 | $3,143.09 | $7,860.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,608.00 / $7,184.00 / $16,000.00
| Facility | | $2,608.00 | $7,184.00 | $16,000.00 |