- 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
- $1,698.36 / $3,214.76 / $6,214.00
| Facility | | $1,698.36 | $3,214.76 | $6,214.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.32 / $590.32 / $616.22
| Facility | | $590.32 | $590.32 | $616.22 |
- 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 / $26,542.00 / $26,542.00
| Facility | | $6,887.55 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.73 / $827.88 / $1,235.99
| Facility | | $659.73 | $827.88 | $1,235.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.73 / $833.86 / $1,320.85
| Facility | | $659.73 | $833.86 | $1,320.85 |
- 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 |