- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $4,265.80 / $10,232.93
| Facility | | $794.33 | $4,265.80 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,000.00
| Facility | | $2,630.27 | $4,786.30 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,995.26 / $8,912.51
| Facility | | $794.33 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,698.24 / $50,118.72
| Facility | | $933.25 | $1,698.24 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $660.69 / $1,862.09
| Facility | | $549.54 | $660.69 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $50,118.72 / $75,857.76
| Facility | | $524.81 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $4,265.80 / $9,549.93
| Facility | | $1,905.46 | $4,265.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $776.25 / $1,584.89
| Facility | | $467.74 | $776.25 | $1,584.89 |