- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.48 / $2,594.00 / $7,495.00
| Facility | | $820.48 | $2,594.00 | $7,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,678.14 / $3,073.23 / $6,065.58
| Facility | | $1,678.14 | $3,073.23 | $6,065.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.25 / $716.25 / $748.18
| Facility | | $716.25 | $716.25 | $748.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,494.86 / $1,494.86 / $1,543.72
| Facility | | $1,494.86 | $1,494.86 | $1,543.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,887.55 / $16,394.00 / $16,394.00
| Facility | | $6,887.55 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.05 / $943.07 / $1,478.33
| Facility | | $711.05 | $943.07 | $1,478.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.44 / $950.25 / $1,540.89
| Facility | | $711.44 | $950.25 | $1,540.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,271.00 / $4,063.00 / $8,226.00
| Facility | | $1,271.00 | $4,063.00 | $8,226.00 |