- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $747.00 / $3,219.00 / $10,893.00
| Facility | | $747.00 | $3,219.00 | $10,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,656.32 / $4,769.29 / $9,266.92
| Facility | | $2,656.32 | $4,769.29 | $9,266.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.17 / $341.17 / $341.17
| Facility | | $341.17 | $341.17 | $341.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,024.76 / $3,024.76 / $3,024.76
| Facility | | $3,024.76 | $3,024.76 | $3,024.76 |
- 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
- $385.17 / $546.20 / $982.70
| Facility | | $385.17 | $546.20 | $982.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.17 / $549.26 / $1,073.06
| Facility | | $385.17 | $549.26 | $1,073.06 |
- 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 |