- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $880.00 / $3,219.00 / $10,893.00
| Facility | | $880.00 | $3,219.00 | $10,893.00 |
- 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
- $770.34 / $770.34 / $804.77
| Facility | | $770.34 | $770.34 | $804.77 |
- 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
- $765.12 / $1,000.27 / $1,483.98
| Facility | | $765.12 | $1,000.27 | $1,483.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $766.15 / $1,020.45 / $1,708.45
| Facility | | $766.15 | $1,020.45 | $1,708.45 |
- 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 |