- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $513.52 / $2,128.00 / $7,513.00
| Facility | | $513.52 | $2,128.00 | $7,513.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,522.48 / $2,664.99 / $5,278.40
| Facility | | $1,522.48 | $2,664.99 | $5,278.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.10 / $275.10 / $474.81
| Facility | | $275.10 | $275.10 | $474.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.11 / $588.11 / $588.11
| Facility | | $588.11 | $588.11 | $588.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,937.04 / $11,500.00 / $12,000.00
| Facility | | $1,937.04 | $11,500.00 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.05 / $536.97 / $911.52
| Facility | | $410.05 | $536.97 | $911.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.91 / $540.52 / $978.42
| Facility | | $410.91 | $540.52 | $978.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,326.00 / $7,600.00
| Facility | | $1,154.00 | $3,326.00 | $7,600.00 |