- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.00 / $3,682.00 / $12,281.00
| Facility | | $921.00 | $3,682.00 | $12,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,888.60 / $5,994.78 / $11,264.07
| Facility | | $2,888.60 | $5,994.78 | $11,264.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.91 / $559.91 / $584.65
| Facility | | $559.91 | $559.91 | $584.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,578.19 / $2,578.19 / $2,662.46
| Facility | | $2,578.19 | $2,578.19 | $2,662.46 |
- 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
- $618.35 / $770.05 / $1,161.26
| Facility | | $618.35 | $770.05 | $1,161.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.35 / $779.85 / $1,268.73
| Facility | | $618.35 | $779.85 | $1,268.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $3,264.00 / $7,600.00
| Facility | | $1,120.00 | $3,264.00 | $7,600.00 |