- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.00 / $3,224.00 / $10,546.00
| Facility | | $727.00 | $3,224.00 | $10,546.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,565.76 / $4,739.10 / $9,037.00
| Facility | | $2,565.76 | $4,739.10 | $9,037.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.02 / $2,444.34 / $2,444.34
| Facility | | $320.02 | $2,444.34 | $2,444.34 |
- 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
- $361.10 / $514.63 / $920.70
| Facility | | $361.10 | $514.63 | $920.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.10 / $515.45 / $1,006.10
| Facility | | $361.10 | $515.45 | $1,006.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,347.00 / $7,600.00
| Facility | | $1,154.00 | $3,347.00 | $7,600.00 |