- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.00 / $2,787.84 / $7,096.46
| Facility | | $632.00 | $2,787.84 | $7,096.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,023.00 / $3,822.09 / $7,494.30
| Facility | | $2,023.00 | $3,822.09 | $7,494.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.53 / $94.53 / $94.53
| Facility | | $94.53 | $94.53 | $94.53 |
- 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 / $16,394.00 / $16,394.00
| Facility | | $9,496.40 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.06 / $144.05 / $254.57
| Facility | | $103.06 | $144.05 | $254.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.06 / $144.91 / $276.18
| Facility | | $104.06 | $144.91 | $276.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,347.00 / $7,600.00
| Facility | | $1,154.00 | $3,347.00 | $7,600.00 |