- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $3,715.35 / $10,000.00
| Facility | | $371.54 | $3,715.35 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,698.24 / $6,165.95
| Facility | | $371.54 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,659.59 / $50,118.72
| Facility | | $446.68 | $1,659.59 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $371.54 / $912.01
| Facility | | $281.84 | $371.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $50,118.72 / $75,857.76
| Facility | | $295.12 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,365.16 / $9,772.37
| Facility | | $2,137.96 | $4,365.16 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $338.84 / $912.01
| Facility | | $213.80 | $338.84 | $912.01 |