- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $828.00 / $3,620.00 / $12,040.00
| Facility | | $828.00 | $3,620.00 | $12,040.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,151.68 / $6,432.06 / $12,314.01
| Facility | | $3,151.68 | $6,432.06 | $12,314.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $277.61 / $4,865.95 / $4,865.95
| Facility | | $277.61 | $4,865.95 | $4,865.95 |
- 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
- $11,500.00 / $26,542.00 / $26,542.00
| Facility | | $11,500.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.70 / $428.54 / $871.05
| Facility | | $312.70 | $428.54 | $871.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.70 / $434.80 / $871.05
| Facility | | $312.70 | $434.80 | $871.05 |
- 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 |