- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.00 / $3,213.00 / $10,836.00
| Facility | | $748.00 | $3,213.00 | $10,836.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,642.82 / $4,719.33 / $9,025.43
| Facility | | $2,642.82 | $4,719.33 | $9,025.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.08 / $480.08 / $480.08
| Facility | | $480.08 | $480.08 | $480.08 |
- 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 / $26,542.00 / $26,542.00
| Facility | | $9,388.90 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.41 / $676.55 / $1,168.97
| Facility | | $520.41 | $676.55 | $1,168.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.41 / $682.02 / $1,349.79
| Facility | | $520.41 | $682.02 | $1,349.79 |
- 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 |