- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.00 / $4,280.02 / $10,296.00
| Facility | | $1,819.00 | $4,280.02 | $10,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,100.00 / $7,264.00 / $12,697.00
| Facility | | $4,100.00 | $7,264.00 | $12,697.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,722.49 / $2,722.49 / $37,499.62
| Facility | | $2,722.49 | $2,722.49 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,188.19 / $2,188.19 / $7,227.90
| Facility | | $2,188.19 | $2,188.19 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $2,250.00 / $4,905.35
| Facility | | $319.00 | $2,250.00 | $4,905.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $2,188.19 / $7,227.90
| Facility | | $555.00 | $2,188.19 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,749.00 / $4,194.00 / $9,300.00
| Facility | | $1,749.00 | $4,194.00 | $9,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,477.21 / $2,477.21 / $6,702.51
| Facility | | $2,477.21 | $2,477.21 | $6,702.51 |