- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $797.00 / $3,213.00 / $10,836.00
| Facility | | $797.00 | $3,213.00 | $10,836.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,520.73 / $6,432.06 / $12,652.54
| Facility | | $3,520.73 | $6,432.06 | $12,652.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.41 / $6,849.60 / $6,849.60
| Facility | | $705.41 | $6,849.60 | $6,849.60 |
- 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 / $26,542.00 / $26,542.00
| Facility | | $11,500.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.09 / $1,000.84 / $1,747.33
| Facility | | $773.09 | $1,000.84 | $1,747.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.09 / $1,002.18 / $2,003.66
| Facility | | $773.09 | $1,002.18 | $2,003.66 |
- 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 |