- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.00 / $2,236.00 / $7,316.00
| Facility | | $488.00 | $2,236.00 | $7,316.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,046.77 / $6,347.43 / $12,610.23
| Facility | | $3,046.77 | $6,347.43 | $12,610.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.08 / $275.08 / $275.08
| Facility | | $275.08 | $275.08 | $275.08 |
- 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 / $12,000.00 / $14,302.50
| Facility | | $11,500.00 | $12,000.00 | $14,302.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.27 / $372.45 / $650.17
| Facility | | $293.27 | $372.45 | $650.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.33 / $380.43 / $755.50
| Facility | | $293.33 | $380.43 | $755.50 |
- 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 |