- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.00 / $2,221.00 / $7,316.00
| Facility | | $632.00 | $2,221.00 | $7,316.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,322.51 / $6,347.43 / $12,610.23
| Facility | | $3,322.51 | $6,347.43 | $12,610.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.61 / $576.61 / $576.61
| Facility | | $576.61 | $576.61 | $576.61 |
- 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
- $635.30 / $824.11 / $1,418.81
| Facility | | $635.30 | $824.11 | $1,418.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $635.30 / $848.46 / $1,629.53
| Facility | | $635.30 | $848.46 | $1,629.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,608.00 / $7,184.00 / $16,000.00
| Facility | | $2,608.00 | $7,184.00 | $16,000.00 |