- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $935.00 / $3,730.00 / $13,004.00
| Facility | | $935.00 | $3,730.00 | $13,004.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,079.35 / $3,872.05 / $7,537.78
| Facility | | $2,079.35 | $3,872.05 | $7,537.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,216.00 / $3,097.38 / $7,097.01
| Facility | | $1,216.00 | $3,097.38 | $7,097.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.62 / $605.62 / $605.62
| Facility | | $605.62 | $605.62 | $605.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,403.30 / $2,403.30 / $2,403.30
| Facility | | $2,403.30 | $2,403.30 | $2,403.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,496.40 / $26,542.00 / $26,542.00
| Facility | | $9,496.40 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.32 / $805.15 / $1,453.42
| Facility | | $625.32 | $805.15 | $1,453.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.32 / $814.52 / $1,703.52
| Facility | | $625.32 | $814.52 | $1,703.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,314.00 / $7,600.00
| Facility | | $1,154.00 | $3,314.00 | $7,600.00 |