- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.00 / $3,102.00 / $9,961.00
| Facility | | $651.00 | $3,102.00 | $9,961.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,647.54 / $2,834.48 / $6,005.55
| Facility | | $1,647.54 | $2,834.48 | $6,005.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $340.76 / $340.76 / $340.76
| Facility | | $340.76 | $340.76 | $340.76 |
- 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
- $365.39 / $469.87 / $823.62
| Facility | | $365.39 | $469.87 | $823.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $365.39 / $474.11 / $949.06
| Facility | | $365.39 | $474.11 | $949.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,284.00 / $4,100.00 / $8,226.00
| Facility | | $1,284.00 | $4,100.00 | $8,226.00 |