- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $951.00 / $3,682.00 / $11,232.00
| Facility | | $951.00 | $3,682.00 | $11,232.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,207.40 / $5,918.41 / $11,569.54
| Facility | | $3,207.40 | $5,918.41 | $11,569.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.91 / $3,244.02 / $3,244.02
| Facility | | $694.91 | $3,244.02 | $3,244.02 |
- 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
- $779.28 / $985.88 / $1,757.89
| Facility | | $779.28 | $985.88 | $1,757.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $784.51 / $1,002.87 / $1,926.00
| Facility | | $784.51 | $1,002.87 | $1,926.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $5,958.00 / $13,134.00
| Facility | | $2,093.00 | $5,958.00 | $13,134.00 |