- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.00 / $3,655.00 / $11,488.25
| Facility | | $714.00 | $3,655.00 | $11,488.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,036.37 / $3,822.09 / $7,494.30
| Facility | | $2,036.37 | $3,822.09 | $7,494.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,980.18 / $7,097.01
| Facility | | $875.00 | $2,980.18 | $7,097.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.93 / $2,017.58 / $2,017.58
| Facility | | $271.93 | $2,017.58 | $2,017.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,403.30 / $2,403.30 / $4,390.00
| Facility | | $2,403.30 | $2,403.30 | $4,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.70 / $26,542.00 / $26,542.00
| Facility | | $1,737.70 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.94 / $393.71 / $715.90
| Facility | | $296.94 | $393.71 | $715.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.52 / $398.92 / $803.35
| Facility | | $297.52 | $398.92 | $803.35 |
- 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 |