- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $3,224.00 / $10,893.00
| Facility | | $803.00 | $3,224.00 | $10,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,665.68 / $4,846.93 / $9,381.18
| Facility | | $2,665.68 | $4,846.93 | $9,381.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.73 / $627.73 / $656.09
| Facility | | $627.73 | $627.73 | $656.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,953.70 / $1,953.70 / $2,017.56
| Facility | | $1,953.70 | $1,953.70 | $2,017.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,001.70 / $26,542.00 / $26,542.00
| Facility | | $9,001.70 | $26,542.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.85 / $842.04 / $1,263.36
| Facility | | $666.85 | $842.04 | $1,263.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.85 / $862.61 / $1,413.09
| Facility | | $666.85 | $862.61 | $1,413.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,200.00 / $10,600.00
| Facility | | $1,634.00 | $4,200.00 | $10,600.00 |