- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $4,073.80 / $10,000.00
| Facility | | $691.83 | $4,073.80 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,995.26 / $8,912.51
| Facility | | $707.95 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,862.09 / $50,118.72
| Facility | | $851.14 | $1,862.09 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $707.95 / $1,778.28
| Facility | | $537.03 | $707.95 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $2,951.21
| Facility | | $2,951.21 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $50,118.72 / $75,857.76
| Facility | | $501.19 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,365.16 / $10,471.29
| Facility | | $2,137.96 | $4,365.16 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $588.84 / $1,513.56
| Facility | | $416.87 | $588.84 | $1,513.56 |