- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.00 / $2,244.00 / $7,513.00
| Facility | | $521.00 | $2,244.00 | $7,513.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,556.83 / $3,133.88 / $6,109.95
| Facility | | $1,556.83 | $3,133.88 | $6,109.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.01 / $342.01 / $357.26
| Facility | | $342.01 | $342.01 | $357.26 |
- 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 / $12,000.00 / $12,000.00
| Facility | | $6,887.55 | $12,000.00 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.52 / $434.65 / $642.66
| Facility | | $354.52 | $434.65 | $642.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.35 / $442.29 / $745.06
| Facility | | $358.35 | $442.29 | $745.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $949.00 / $2,287.00
| Facility | | $157.00 | $949.00 | $2,287.00 |