- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.00 / $3,219.00 / $11,453.00
| Facility | | $748.00 | $3,219.00 | $11,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,292.00 / $8,263.51 / $16,141.40
| Facility | | $4,292.00 | $8,263.51 | $16,141.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.72 / $537.72 / $537.72
| Facility | | $537.72 | $537.72 | $537.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,434.96 / $4,434.96 / $4,434.96
| Facility | | $4,434.96 | $4,434.96 | $4,434.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $26,542.00 / $26,542.00
| Facility | | $11,500.00 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $463.08 / $605.13 / $1,136.86
| Facility | | $463.08 | $605.13 | $1,136.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $463.08 / $611.80 / $1,223.24
| Facility | | $463.08 | $611.80 | $1,223.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $28,401.00
| Facility | | $2,093.00 | $6,000.00 | $28,401.00 |