- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.91 / $2,221.00 / $7,316.00
| Facility | | $605.91 | $2,221.00 | $7,316.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,279.81 / $6,347.43 / $12,610.23
| Facility | | $3,279.81 | $6,347.43 | $12,610.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.48 / $549.48 / $549.48
| Facility | | $549.48 | $549.48 | $549.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,860.97 / $6,860.97 / $6,860.97
| Facility | | $6,860.97 | $6,860.97 | $6,860.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $12,000.00 / $27,110.45
| Facility | | $11,500.00 | $12,000.00 | $27,110.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.91 / $805.96 / $1,351.56
| Facility | | $605.91 | $805.96 | $1,351.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.91 / $805.96 / $1,558.31
| Facility | | $605.91 | $805.96 | $1,558.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |