- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $872.00 / $3,219.00 / $10,893.00
| Facility | | $872.00 | $3,219.00 | $10,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,814.35 / $4,909.47 / $9,381.18
| Facility | | $2,814.35 | $4,909.47 | $9,381.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.49 / $2,592.90 / $2,592.90
| Facility | | $758.49 | $2,592.90 | $2,592.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,953.70 / $1,953.70 / $2,017.56
| Facility | | $1,953.70 | $1,953.70 | $2,017.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,001.70 / $26,542.00 / $26,542.00
| Facility | | $9,001.70 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.19 / $971.47 / $1,403.21
| Facility | | $763.19 | $971.47 | $1,403.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.34 / $989.38 / $1,647.42
| Facility | | $773.34 | $989.38 | $1,647.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,200.00 / $10,600.00
| Facility | | $1,634.00 | $4,200.00 | $10,600.00 |