- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $2,673.00 / $7,495.00
| Facility | | $652.00 | $2,673.00 | $7,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,535.57 / $4,708.92 / $9,025.43
| Facility | | $2,535.57 | $4,708.92 | $9,025.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.38 / $2,613.51 / $2,613.51
| Facility | | $295.38 | $2,613.51 | $2,613.51 |
- 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 / $16,394.00 / $16,394.00
| Facility | | $9,388.90 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.87 / $444.97 / $892.45
| Facility | | $323.87 | $444.97 | $892.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.87 / $450.08 / $892.45
| Facility | | $323.87 | $450.08 | $892.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,284.00 / $4,100.00 / $8,226.00
| Facility | | $1,284.00 | $4,100.00 | $8,226.00 |