- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.00 / $2,747.00 / $7,495.00
| Facility | | $712.00 | $2,747.00 | $7,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,686.50 / $4,739.10 / $9,266.92
| Facility | | $2,686.50 | $4,739.10 | $9,266.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $558.30 / $558.30 / $558.30
| Facility | | $558.30 | $558.30 | $558.30 |
- 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
- $614.91 / $790.93 / $1,380.61
| Facility | | $614.91 | $790.93 | $1,380.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $614.91 / $791.61 / $1,582.34
| Facility | | $614.91 | $791.61 | $1,582.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $13,134.00
| Facility | | $2,093.00 | $6,000.00 | $13,134.00 |