- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $2,550.00 / $7,495.00
| Facility | | $624.00 | $2,550.00 | $7,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,576.68 / $2,799.05 / $5,646.61
| Facility | | $1,576.68 | $2,799.05 | $5,646.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.13 / $234.13 / $234.13
| Facility | | $234.13 | $234.13 | $234.13 |
- 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
- $259.98 / $345.54 / $579.14
| Facility | | $259.98 | $345.54 | $579.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.98 / $347.00 / $668.46
| Facility | | $259.98 | $347.00 | $668.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,226.00 / $7,600.00
| Facility | | $1,154.00 | $3,226.00 | $7,600.00 |