- 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
- $1,738.90 / $3,076.97 / $6,214.00
| Facility | | $1,738.90 | $3,076.97 | $6,214.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.58 / $584.58 / $610.46
| Facility | | $584.58 | $584.58 | $610.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,263.04 / $1,263.04 / $1,304.32
| Facility | | $1,263.04 | $1,263.04 | $1,304.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,819.45 / $26,542.00 / $26,542.00
| Facility | | $5,819.45 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.22 / $888.86 / $1,540.27
| Facility | | $695.22 | $888.86 | $1,540.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.22 / $909.89 / $1,684.65
| Facility | | $695.22 | $909.89 | $1,684.65 |
- 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 |