- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $3,454.30 / $8,017.00
| Facility | | $882.00 | $3,454.30 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.07 / $825.07 / $825.07
| Facility | | $825.07 | $825.07 | $825.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,124.74 / $6,874.07 / $21,597.54
| Facility | | $4,124.74 | $6,874.07 | $21,597.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.61 / $3,839.00 / $8,017.00
| Facility | | $924.61 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.07 / $825.07 / $825.07
| Facility | | $825.07 | $825.07 | $825.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $642.92 / $710.25 / $710.25
| Facility | | $642.92 | $710.25 | $710.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |