- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.00 / $3,188.00 / $10,836.00
| Facility | | $732.00 | $3,188.00 | $10,836.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,686.50 / $4,739.10 / $9,025.43
| Facility | | $2,686.50 | $4,739.10 | $9,025.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.55 / $3,204.71 / $3,204.71
| Facility | | $292.55 | $3,204.71 | $3,204.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,376.10 / $2,376.10 / $2,376.10
| Facility | | $2,376.10 | $2,376.10 | $2,376.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,388.90 / $26,542.00 / $26,542.00
| Facility | | $9,388.90 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.14 / $438.56 / $901.06
| Facility | | $323.14 | $438.56 | $901.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.14 / $444.03 / $914.59
| Facility | | $323.14 | $444.03 | $914.59 |
- 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 |