- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $872.00 / $3,601.00 / $10,893.00
| Facility | | $872.00 | $3,601.00 | $10,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,656.32 / $4,799.47 / $9,266.92
| Facility | | $2,656.32 | $4,799.47 | $9,266.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.35 / $213.35 / $213.35
| Facility | | $213.35 | $213.35 | $213.35 |
- 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
- $240.80 / $328.71 / $661.19
| Facility | | $240.80 | $328.71 | $661.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.80 / $333.61 / $671.03
| Facility | | $240.80 | $333.61 | $671.03 |
- 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 |