- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $853.50 / $3,682.00 / $11,139.00
| Facility | | $853.50 | $3,682.00 | $11,139.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,227.31 / $3,947.00 / $7,569.24
| Facility | | $2,227.31 | $3,947.00 | $7,569.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.47 / $488.47 / $488.47
| Facility | | $488.47 | $488.47 | $488.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,403.30 / $2,403.30 / $6,190.00
| Facility | | $2,403.30 | $2,403.30 | $6,190.00 |
- 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
- $545.27 / $711.05 / $1,205.64
| Facility | | $545.27 | $711.05 | $1,205.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.27 / $719.98 / $1,465.63
| Facility | | $545.27 | $719.98 | $1,465.63 |
- 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 |